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State regulation of practice and the...

Sonenberg, Andrea.

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State regulation of practice and the utilization of certified nurse-midwives for Medicaid-funded prenatal care.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	State regulation of practice and the utilization of certified nurse-midwives for Medicaid-funded prenatal care./
Author:	Sonenberg, Andrea.
Description:	125 p.
Notes:	Source: Dissertation Abstracts International, Volume: 68-06, Section: B, page: 3732.
Contained By:	Dissertation Abstracts International68-06B.
Subject:	Health Sciences, Nursing. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3266679
ISBN:	9780549057239

State regulation of practice and the utilization of certified nurse-midwives for Medicaid-funded prenatal care.
Sonenberg, Andrea.

State regulation of practice and the utilization of certified nurse-midwives for Medicaid-funded prenatal care. - 125 p.

Source: Dissertation Abstracts International, Volume: 68-06, Section: B, page: 3732.

Thesis (D.N.Sc.)--Columbia University, 2007.

In response to the continuing high percents of low birth weight and premature birth in the United States, one of the goals of Healthy People 2010 is for 90% of pregnant women are to receive prenatal care beginning in their first trimester of pregnancy. The aims of this descriptive correlational design health policy study utilizing multiple secondary data sets were to: (1) describe any association between a state's CNM Scope Index score and the proportion of Medicaid funded services delivered by CNMs in each of the fifty states of the United States; (2) describe any association between a state's CNM Scope Index score and the proportion of Medicaid-funded prenatal care delivered by CNMs in exemplar states representing the extremes on the Scope of Practice Index; (3) describe the category of regulation of practice (legal status, reimbursement policies, or prescriptive privileges) within the index that has the greatest association with the proportion of Medicaid-funded services delivered by CNMs; and (4)describe which of the factors within the most influential category had the greatest association with the proportion of Medicaid-funded services delivered by CNMs. The four key findings were: (1) there is a paucity of data related to individual and specific Medicaid funded services provided by nurse-midwives; (2) states with the fewest barriers to practice have the greatest proportion of CNM births; (3) states with the most restrictive practice regulation also have the highest proportion of vulnerable populations (minority and populations in poverty) and higher percents of adverse perinatal outcomes (low birth weight, premature birth, and neonatal mortality); and (4) states with the greatest autonomy in three areas: professionalism (legal status), business practices (reimbursement), and clinical practice (prescriptive authority) may have the greatest access to care for vulnerable populations. Future studies should focus on improving research methodologies in the areas of state regulation and outcomes of nurse-midwifery practice, specifically those related to data collection. Health policy implications fall into three categories: organizational policy related to research and nurse-midwifery practice, regulation of nurse-midwifery practice, and access to nurse-midwifery care for vulnerable populations of women.

ISBN: 9780549057239Subjects--Topical Terms:

1017798
Health Sciences, Nursing.

State regulation of practice and the utilization of certified nurse-midwives for Medicaid-funded prenatal care.
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520 $a In response to the continuing high percents of low birth weight and premature birth in the United States, one of the goals of Healthy People 2010 is for 90% of pregnant women are to receive prenatal care beginning in their first trimester of pregnancy. The aims of this descriptive correlational design health policy study utilizing multiple secondary data sets were to: (1) describe any association between a state's CNM Scope Index score and the proportion of Medicaid funded services delivered by CNMs in each of the fifty states of the United States; (2) describe any association between a state's CNM Scope Index score and the proportion of Medicaid-funded prenatal care delivered by CNMs in exemplar states representing the extremes on the Scope of Practice Index; (3) describe the category of regulation of practice (legal status, reimbursement policies, or prescriptive privileges) within the index that has the greatest association with the proportion of Medicaid-funded services delivered by CNMs; and (4)describe which of the factors within the most influential category had the greatest association with the proportion of Medicaid-funded services delivered by CNMs. The four key findings were: (1) there is a paucity of data related to individual and specific Medicaid funded services provided by nurse-midwives; (2) states with the fewest barriers to practice have the greatest proportion of CNM births; (3) states with the most restrictive practice regulation also have the highest proportion of vulnerable populations (minority and populations in poverty) and higher percents of adverse perinatal outcomes (low birth weight, premature birth, and neonatal mortality); and (4) states with the greatest autonomy in three areas: professionalism (legal status), business practices (reimbursement), and clinical practice (prescriptive authority) may have the greatest access to care for vulnerable populations. Future studies should focus on improving research methodologies in the areas of state regulation and outcomes of nurse-midwifery practice, specifically those related to data collection. Health policy implications fall into three categories: organizational policy related to research and nurse-midwifery practice, regulation of nurse-midwifery practice, and access to nurse-midwifery care for vulnerable populations of women.
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