 |
2002 PRAMS Surveillance Report: Multistate Exhibits
Infant Follow-Up and Well-Baby Care |
|
Data Highlights | References | Tables
Background
Traditionally, clinicians were able to assess and monitor closely the medical and psychological needs of newborns and their mothers during the important first few days following birth in the hospital setting. Beginning in the 1970s, public pressure to demedicalize childbirth resulted in declining hospital lengths of stay after normal childbirth. This trend accelerated in the early 1990s as pressure to contain health care costs increased.1,2 The average length of a hospital stay for a well newborn declined from 3.2 days in 1980 to 1.7 days in 1995.3
Concerns that reduced access to care in the hospital setting following birth would lead to adverse health outcomes for infants and their mothers prompted professional organizations to publish guidelines for length of birth- and delivery-related stays. In 1992, the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) jointly published the Guidelines for Perinatal Care in which they recommended postpartum hospital stays of at least 48 hours for uncomplicated vaginal deliveries and at least 96 hours for uncomplicated cesarean deliveries.4 In 1995, the AAP further recommended that newborns receive follow-up care in the office or home within 48 hours of an early discharge, defined as a stay under 48 hours for uncomplicated vaginal delivery and a stay under 96 hours for an uncomplicated cesarean delivery.5 The guidelines regarding lengths of postpartum hospital stay and follow-up care for infants discharged early are retained in the most current (2002) Guidelines for Perinatal Care.6
In the mid-1990s, 43 states and the federal government backed up these recommendations by enacting legislation mandating insurance coverage of birth- and delivery-related hospital stays of the standard duration recommended by the AAP and ACOG.2 Many states also required coverage of postdischarge home or office follow-up for vaginally delivered newborns with stays under 48 hours and cesarean-delivered newborns with stays less than 96 hours. The federal legislation does not include requirements for infant follow-up care.
Following the legislation, the incidence of early discharge declined and the average lengths of stay for newborns and their mothers increased. By 2001, the average length of stay for a well newborn had increased to 2.1 days.3 However, many newborns continue to be discharged early and many of these infants fail to receive early follow-up care.1,7,8 A study of births in California in 1999 found that the odds of untimely follow-up were greater among mothers with lower incomes, Medicaid coverage, Latino ethnicity, and non-English language.7
The clinical rationale for the follow-up care recommendation was that jaundice peaks and breast milk comes in at 72 to 96 hours after delivery. However, evidence in the literature concerning the impact of early discharge on newborn morbidity is inconclusive: some studies show early discharge increasing newborn morbidity,1,9–15 while others do not.16–19 Little evidence exists on the impact of early follow-up care on newborn morbidity. A recent study of Ohio Medicaid claims linked to birth certificates for 1991 to 1998 suggests that for newborns with early discharge, early follow-up visits may reduce rehospitalizations within the first 10 days of life.1
Beyond early postdischarge follow-up care, the AAP recommends routine well-baby visits for infants at 1 week and at 1, 2, 4, 6, 9, and 12 months.20 These visits are used to track growth and development; administer immunizations, screening tests, and health assessments; and provide health education and guidance to parents.21 They are particularly important for infants at risk for health problems and for families adjusting to new parenthood. Well-baby visits also provide an opportunity for health care workers to screen the mother for domestic violence and postpartum depression.22
Studies have found that well-baby visits are underutilized in the United States. Data from the 1988 National Maternal and Infant Health Survey (NMIHS) suggested that fewer than one-half of infants under 6 months of age were compliant with the AAP guidelines.23 Furthermore, black and Hispanic infants were much less likely to have received all recommended well-baby visits. Ronsaville and Hakim23 found that 58% of white infants had received all recommended visits, but only 35% of black infants and 37% of Hispanic infants were compliant with the AAP guidelines. No more recent national data exist to determine current rates of compliance among infants under 6 months of age. However, benchmark data from the Health Plan Employer Data and Information Set (HEDIS) suggest that higher compliance with recommended well-child schedules continues to elude commercial and Medicaid managed care plans; in 2002, only 58% of children aged 3 through 6 years in managed care plans received the recommended number of visits.24
PRAMS collects data on whether infants were discharged early, whether they were seen by a primary health care practitioner in the first week postdischarge, and the proportion of infants who receive sufficient well-baby care up to the time of the interview. Sufficient well-baby care is defined as an infant receiving 2 or more checkups by 2–3 months (60–122 days) of age; 3 or more checkups by 4–5 months (123–183 days) of age; or 4 or more checkups by 6–9 months (184–274 days) of age. With these data, states can track compliance with length-of-stay, early follow-up, and well-baby visit guidelines.
Data Highlights
- In 2002, the proportion of infants discharged from the hospital within 48 hours of their birth ranged from 49.8% (New Jersey) to 70.4% (Utah and Washington). Among these infants, the proportion who received a checkup within 1 week of their early discharge ranged from 58.3% (North Dakota) to 90.6% (Washington).
- During 2000–2002, the proportion of infants discharged from the hospital within 48 hours of their birth decreased in 6 states (Alabama, Florida, Nebraska, North Carolina, Utah, and Washington). During this same period, the proportion of infants who received a checkup within 1 week of their early hospital discharge (within 48 hours after birth) increased in 5 states (Arkansas, Florida, Illinois, North Carolina, and Utah).
- In 2002, the proportion of infants who received sufficient well-baby care ranged from 76.1% (Alaska) to 94.8% (Rhode Island).
- During 2000–2002, the proportion of infants who received sufficient well-baby care increased in 1 state (Louisiana) and decreased in another (Alaska).
References
- Meara E, Kotagal UR, Atherton HD, Lieu TA. Impact of early newborn discharge legislation and early follow-up visits on infant outcomes in a state Medicaid population. Pediatrics 2004;113(6):1619–1627.
- Eaton AP. Early postpartum discharge: recommendations from a preliminary report to Congress. Pediatrics 2001;107(2):400–403.
- Kozak LJ, Owings MF, Hall MJ. National Hospital Discharge Survey: 2001 annual summary with detailed diagnosis and procedure data. Vital and Health Statistics 2004;13(156): i–v, 1–198.
- American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG). Guidelines for Perinatal Care. Elk Grove Village, IL and Washington, DC: AAP and ACOG; 1992.
- American Academy of Pediatrics Committee on Fetus and Newborn. Hospital stay for healthy term newborns. Pediatrics 1995;96(4 Part 1):788–790.
- American Academy of Pediatrics (AAP) Committee on the Fetus and Newborn and American College of Obstetricians and Gynecologists (ACOG) Committee on Obstetric Practice. Guidelines for Perinatal Care. Elk Grove Village, IL and Washington, DC: AAP and ACOG; 2002.
- Galbraith AA, Egerter SA, Marchi KS, Chavez G, Braveman PA. Newborn early discharge revisited: are California newborns receiving recommended postnatal services? Pediatrics 2003;111(2):364–371.
- Madlon-Kay DJ, DeFor TA, Egerter S. Newborn length of stay, health care utilization, and the effect of Minnesota legislation. Archives of Pediatric and Adolescent Medicine 2003;157(6):579–583.
- Lee KS, Perlman M, Ballantyne M, Elliott I, To T. Association between duration of neonatal hospital stay and readmission rate. The Journal of Pediatrics 1995;127(5):758–766.
- Liu LL, Clemens CJ, Shay DK, Davis RL, Novack AH. The safety of newborn early discharge. The Washington State experience. JAMA (Journal of the American Medical Association) 1997;278(4):293–298.
- Gazmararian JA, Koplan JP, Cogswell ME, Bailey CM, Davis NA, Cutler CM. Maternity experiences in a managed care organization. Health Affairs 1997;16(3):198–208.
- Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatrics 1998;101(6):995–998.
- Grupp-Phelan J, Taylor JA, Liu LL, Davis RL. Early newborn hospital discharge and readmission for mild and severe jaundice. Archives of Pediatric and Adolescent Medicine 1999;153(12):1283–1288.
- Lane DA, Kauls LS, Ickovics JR, Naftolin F, Feinstein AR. Early postpartum discharges. Impact on distress and outpatient problems. Archives of Family Medicine 1999;8(3):237–242.
- Malkin JD, Broder MS, Keeler E. Do longer postpartum stays reduce newborn readmissions? Analysis using instrumental variables. Health Services Research 2000;35(5 Part 2):1071–1091.
- Gazmararian JA, Koplan JP. Length-of-stay after delivery: managed care versus fee-for-service. Health Affairs 1996;15(4):74–80.
- Meikle SF, Lyons E, Hulac P, Orleans M. Rehospitalizations and outpatient contacts of mothers and neonates after hospital discharge after vaginal delivery. American Journal of Obstetrics and Gynecology 1998;179(1):166–171.
- Kotagal UR, Atherton HD, Eshett R, Schoettker PJ, Perlstein PH. Safety of early discharge for Medicaid newborns. JAMA (Journal of the American Medical Association) 1999;282(12):1150–156.
- Madden JM, Soumerai SB, Lieu TA, Mandl KD, Zhang F, Ross-Degnan D. Length-of-stay policies and ascertainment of postdischarge problems in newborns. Pediatrics 2004;113(1 Part 1):42–49.
- American Academy of Pediatrics Committee on Practice and Ambulatory Medicine. Recommendations for preventative pediatric health care. Pediatrics 2000;105(3):645–646.
- Shelov SP, Hannemann RE, editors. Caring for Your Baby and Young Child: Birth to Age 5. Elk Grove Village, IL: American Academy of Pediatrics; 2004.
- Logsdon MC, Birkimer JC, Usui WM. The link of social support and postpartum depressive symptoms in African-American women with low incomes. The American Journal of Maternal Child Nursing 2000;25(5):262–266.
- Ronsaville DS, Hakim RB. Well child care in the United States: racial differences in compliance with guidelines. American Journal of Public Health 2000;90(9):1436–1443.
- National Association of State Medicaid Directors (NASMD). Medicaid HEDIS 2002 Database Report. Washington, DC: NASMD; 2003.
Prevalence of Infant Discharge from Hospital Within 48 Hours, 2002
| State |
Respondents |
Percent† |
Standard Error |
95% CI‡ |
| Alabama |
1,528 |
54.1 |
1.6 |
51.0–57.2 |
| Alaska |
1,579 |
69.2 |
1.3 |
66.6–71.7 |
| Arkansas |
1,937 |
67.8 |
1.4 |
64.9–70.5 |
| Colorado |
2,225 |
69.2 |
1.2 |
66.7–71.5 |
| Florida |
1,982 |
56.1 |
1.7 |
52.8–59.3 |
| Hawaii |
1,793 |
65.4 |
1.4 |
62.7–68.0 |
| Illinois |
1,922 |
63.7 |
1.2 |
61.4–65.9 |
| Louisiana |
1,660 |
54.9 |
1.4 |
52.2–57.6 |
| Maine |
1,125 |
60.7 |
1.6 |
57.5–63.9 |
| Maryland |
1,443 |
57.6 |
1.9 |
53.8–61.4 |
| Michigan |
1,527 |
66.8 |
1.3 |
64.1–69.4 |
| Minnesotaa |
1,140 |
64.0 |
1.8 |
60.4–67.5 |
| Montana |
1,019 |
67.2 |
1.5 |
64.2–70.1 |
| Nebraska |
1,874 |
62.0 |
1.4 |
59.3–64.6 |
| New Jerseyb |
935 |
49.8 |
1.9 |
46.1–53.6 |
| New Mexico |
1,533 |
69.5 |
1.2 |
67.0–71.9 |
| New Yorkc |
1,209 |
60.4 |
1.8 |
56.9–63.8 |
| North Carolina |
1,529 |
62.3 |
1.5 |
59.3–65.2 |
| North Dakota |
904 |
64.6 |
1.6 |
61.5–67.7 |
| Ohio |
1,356 |
66.0 |
1.6 |
62.8–69.1 |
| Oklahoma |
1,831 |
62.8 |
1.7 |
59.3–66.1 |
| Rhode Island |
1,401 |
58.1 |
1.5 |
55.1–61.1 |
| South Carolina |
1,359 |
58.0 |
2.1 |
53.9–62.1 |
| Utah |
1,542 |
70.4 |
1.5 |
67.5–73.2 |
| Vermont |
1,077 |
65.8 |
1.4 |
63.0–68.5 |
| Washington |
1,496 |
70.4 |
1.7 |
66.9–73.6 |
| West Virginia |
1,659 |
65.2 |
1.6 |
62.0–68.3 |
| All PRAMS states§ |
40,585 |
62.2 |
0.4 |
61.4–63.0 |
† 2002 state range is 49.8–70.4%.
‡ Confidence interval.
§ Aggregate of the 27 PRAMS states.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City. |
Prevalence of Infant Discharge from Hospital Within 48 Hours, 2002
Prevalence of Infant Discharge from Hospital Within 48 Hours, 2000–2002
| State |
2000
(%) |
2001
(%) |
2002
(%) |
P value
for trend# |
| Alabama |
58.6 |
57.0 |
54.1 |
0.045* |
| Alaska |
70.1 |
69.7 |
69.2 |
0.610 |
| Arkansas |
69.2 |
69.6 |
67.8 |
0.508 |
| Colorado |
72.3 |
74.0 |
69.2 |
0.070 |
| Florida |
61.1 |
56.5 |
56.1 |
0.030* |
| Hawaii |
67.3 |
66.1 |
65.4 |
0.262 |
| Illinois |
66.1 |
66.5 |
63.7 |
0.128 |
| Louisiana |
57.8 |
53.6 |
54.9 |
0.113 |
| Maine |
64.0 |
63.4 |
60.7 |
0.155 |
| Maryland |
— |
59.6d |
57.6 |
# # |
| Michigan |
— |
68.5e |
66.8 |
# # |
| Minnesota |
— |
— |
64.0a |
# # |
| Montana |
— |
— |
67.2 |
# # |
| Nebraska |
66.6 |
60.3 |
62.0 |
0.012* |
| New Jersey |
— |
— |
49.8b |
# # |
| New Mexico |
72.6 |
72.7 |
69.5 |
0.067 |
| New Yorkc |
62.5 |
58.5 |
60.4 |
0.383 |
| North Carolina |
69.7 |
64.2 |
62.3 |
0.000** |
| North Dakota |
— |
— |
64.6 |
# # |
| Ohio |
66.0 |
66.3 |
66.0 |
0.988 |
| Oklahoma |
66.0 |
66.1 |
62.8 |
0.191 |
| Rhode Island |
— |
— |
58.1 |
# # |
| South Carolina |
61.6 |
57.4 |
58.0 |
0.210 |
| Utah |
75.3 |
72.3 |
70.4 |
0.015* |
| Vermont |
—f |
72.0f |
65.8 |
# # |
| Washington |
75.4 |
72.6 |
70.4 |
0.027* |
| West Virginia |
66.9 |
67.7 |
65.2 |
0.462 |
# Based on a test for linear trend using logistic regression.
* p value is less than 0.05.
** p value is less than 0.001.
# # < 3 years of data available; test for linear trend not applicable.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City.
d Data represent Maryland births from February–December 2001.
e Data represent Michigan births from July–December 2001.
f Data represent Vermont births from October 2000–December 2001. |
Prevalence of Infant Checkup Within 1 Week of Hospital Discharge for Infants Discharged Within 48 Hours, 2002
| State |
Respondents |
Percent† |
Standard Error |
95% CI‡ |
| Alabama |
568 |
63.8 |
2.2 |
59.3–68.0 |
| Alaska |
877 |
77.5 |
1.4 |
74.6–80.1 |
| Arkansas |
1,009 |
74.6 |
1.7 |
71.1–77.7 |
| Colorado |
1,280 |
88.2 |
1.1 |
85.8–90.2 |
| Florida |
731 |
83.4 |
1.8 |
79.7–86.6 |
| Hawaii |
1,130 |
82.3 |
1.4 |
79.4–85.0 |
| Illinois |
1,071 |
82.0 |
1.2 |
79.5–84.3 |
| Louisiana |
698 |
71.8 |
1.7 |
68.3–75.1 |
| Maine |
529 |
76.8 |
1.9 |
72.9–80.3 |
| Maryland |
594 |
83.8 |
2.0 |
79.6–87.4 |
| Michigan |
862 |
82.3 |
1.4 |
79.4–84.9 |
| Minnesotaa |
668 |
74.4 |
2.1 |
70.1–78.3 |
| Montana |
650 |
83.9 |
1.5 |
80.8–86.7 |
| Nebraska |
1,094 |
78.1 |
1.5 |
75.0–80.8 |
| New Jerseyb |
442 |
72.8 |
2.5 |
67.6–77.3 |
| New Mexico |
1,036 |
86.4 |
1.1 |
84.2–88.4 |
| New Yorkc |
522 |
75.2 |
2.2 |
70.8–79.2 |
| North Carolina |
692 |
87.1 |
1.4 |
84.1–89.6 |
| North Dakota |
571 |
58.3 |
2.0 |
54.2–62.3 |
| Ohio |
640 |
77.4 |
1.9 |
73.4–81.0 |
| Oklahoma |
719 |
65.5 |
2.3 |
60.8–69.9 |
| Rhode Island |
629 |
87.5 |
1.4 |
84.4–90.0 |
| South Carolina |
395 |
76.6 |
2.5 |
71.3–81.1 |
| Utah |
887 |
63.4 |
1.9 |
59.5–67.1 |
| Vermont |
640 |
84.4 |
1.4 |
81.4–86.9 |
| Washington |
994 |
90.6 |
1.3 |
87.8–92.9 |
| West Virginia |
794 |
74.9 |
1.9 |
70.9–78.5 |
| All PRAMS states§ |
20,722 |
79.5 |
0.4 |
78.7–80.3 |
† 2002 state range is 58.3–90.6%.
‡ Confidence interval.
§ Aggregate of the 27 PRAMS states.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City. |
Prevalence of Infant Checkup Within 1 Week of Hospital Discharge for Infants Discharged Within 48 Hours, 2002
Prevalence of Infant Checkup Within 1 Week of Hospital Discharge for Infants Discharged Within 48 Hours, 2000–2002
| State |
2000
(%) |
2001
(%) |
2002
(%) |
P value
for trend# |
| Alabama |
65.7 |
64.6 |
63.8 |
0.515 |
| Alaska |
73.9 |
76.0 |
77.5 |
0.089 |
| Arkansas |
65.4 |
72.0 |
74.6 |
0.001** |
| Colorado |
88.6 |
88.0 |
88.2 |
0.818 |
| Florida |
77.9 |
78.3 |
83.4 |
0.035* |
| Hawaii |
79.6 |
82.1 |
82.3 |
0.140 |
| Illinois |
76.9 |
79.2 |
82.0 |
0.004* |
| Louisiana |
69.4 |
70.0 |
71.8 |
0.296 |
| Maine |
78.6 |
79.8 |
76.8 |
0.491 |
| Maryland |
— |
83.9d |
83.8 |
# # |
| Michigan |
— |
76.2e |
82.3 |
# # |
| Minnesota |
— |
— |
74.4a |
# # |
| Montana |
— |
— |
83.9 |
# # |
| Nebraska |
75.7 |
78.7 |
78.1 |
0.241 |
| New Jersey |
— |
— |
72.8b |
# # |
| New Mexico |
84.9 |
87.3 |
86.4 |
0.322 |
| New Yorkc |
78.5 |
79.1 |
75.2 |
0.275 |
| North Carolina |
79.8 |
84.8 |
87.1 |
0.001** |
| North Dakota |
— |
— |
58.3 |
# # |
| Ohio |
78.2 |
77.9 |
77.4 |
0.778 |
| Oklahoma |
67.0 |
70.1 |
65.5 |
0.641 |
| Rhode Island |
— |
— |
87.5 |
# # |
| South Carolina |
75.1 |
75.1 |
76.6 |
0.670 |
| Utah |
51.5 |
55.4 |
63.4 |
0.000** |
| Vermont |
—f |
83.8f |
84.4 |
# # |
| Washington |
87.3 |
88.2 |
90.6 |
0.081 |
| West Virginia |
73.8 |
72.3 |
74.9 |
0.695 |
# Based on a test for linear trend using logistic regression.
* p value is less than 0.05.
** p value is less than 0.001.
# # < 3 years of data available; test for linear trend not applicable.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City.
d Data represent Maryland births from February–December 2001.
e Data represent Michigan births from July–December 2001.
f Data represent Vermont births from October 2000–December 2001. |
Prevalence of Sufficient Well-Baby Care, 2002
| State |
Respondents |
Percent† |
Standard Error |
95% CI‡ |
| Alabama |
1,318 |
83.7†† |
1.2 |
81.1–86.0 |
| Alaska |
1,415 |
76.1 |
1.2 |
73.6–78.4 |
| Arkansas |
1,831 |
78.3 |
1.3 |
75.6–80.7 |
| Colorado |
2,071 |
85.8 |
1.0 |
83.7–87.6 |
| Florida |
1,747 |
80.4 |
1.4 |
77.6–83.0 |
| Hawaii |
1,654 |
84.2 |
1.1 |
82.0–86.2 |
| Illinois |
1,783 |
89.2 |
0.8 |
87.5–90.6 |
| Louisiana |
1,387 |
81.6†† |
1.1 |
79.3–83.7 |
| Maine |
1,035 |
87.6 |
1.1 |
85.2–89.7 |
| Maryland |
1,293 |
89.4 |
1.3 |
86.6–91.7 |
| Michigan |
1,357 |
80.8 |
1.2 |
78.3–83.1 |
| Minnesotaa |
1,030 |
84.4 |
1.4 |
81.5–87.0 |
| Montana |
1,003 |
81.0 |
1.3 |
78.3–83.4 |
| Nebraska |
1,690 |
83.6 |
1.0 |
81.4–85.5 |
| New Jerseyb |
864 |
89.4 |
1.1 |
87.0–91.4 |
| New Mexico |
1,410 |
78.0 |
1.2 |
75.7–80.2 |
| New Yorkc |
1,087 |
90.9 |
1.1 |
88.4–92.9 |
| North Carolina |
1,382 |
85.7 |
1.2 |
83.2–87.8 |
| North Dakota |
848 |
79.0 |
1.4 |
76.1–81.6 |
| Ohio |
1,193 |
87.0 |
1.2 |
84.5–89.2 |
| Oklahoma |
1,601 |
76.9 |
1.6 |
73.6–79.9 |
| Rhode Island |
1,268 |
94.8 |
0.7 |
93.2–96.0 |
| South Carolina |
1,098 |
80.3†† |
1.8 |
76.5–83.7 |
| Utah |
1,396 |
82.8 |
1.3 |
80.1–85.2 |
| Vermont |
1,037 |
84.7 |
1.1 |
82.4–86.7 |
| Washington |
1,419 |
83.3 |
1.4 |
80.3–85.9 |
| West Virginia |
1,485 |
85.6 |
1.3 |
82.9–87.9 |
| All PRAMS states§ |
36,702 |
84.6 |
0.3 |
84.0–85.2 |
Note: Sufficient well-baby care is defined as an infant receiving
2 or more checkups by 2–3 months (60–122 days) of age;
3 or more checkups by 4–5 months (123–183 days) of age; or
4 or more checkups by 6–9 months (184–274 days) of age.
† 2002 state range is 76.1–94.8%.
‡ Confidence interval.
§ Aggregate of the 27 PRAMS states.
†† Missing ≥ 10% data.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City. |
Prevalence of Sufficient Well-Baby Care, 2002
Prevalence of Sufficient Well-Baby Care, 2000–2002
| State |
2000
(%) |
2001
(%) |
2002
(%) |
P value
for trend# |
| Alabama |
86.1 |
86.8 |
83.7†† |
0.181 |
| Alaska |
80.5 |
78.3 |
76.1 |
0.010* |
| Arkansas |
75.7 |
78.2 |
78.3 |
0.223 |
| Colorado |
83.8 |
82.3 |
85.8 |
0.164 |
| Florida |
81.0 |
79.6 |
80.4 |
0.775 |
| Hawaii |
85.4†† |
83.0†† |
84.2 |
0.397 |
| Illinois |
87.8 |
89.3 |
89.2 |
0.233 |
| Louisiana |
75.2†† |
80.5†† |
81.6†† |
0.000** |
| Maine |
87.7 |
87.4 |
87.6 |
0.965 |
| Maryland |
— |
90.6††d |
89.4 |
# # |
| Michigan |
— |
80.4††e |
80.8 |
# # |
| Minnesota |
— |
— |
84.4a |
# # |
| Montana |
— |
— |
81.0 |
# # |
| Nebraska |
85.6 |
81.8 |
83.6 |
0.158 |
| New Jersey |
— |
— |
89.4b |
# # |
| New Mexico |
80.6 |
78.9 |
78.0 |
0.100 |
| New Yorkc |
89.3 |
88.9 |
90.9 |
0.339 |
| North Carolina |
83.9 |
85.1 |
85.7 |
0.280 |
| North Dakota |
— |
— |
79.0 |
# # |
| Ohio |
84.8 |
81.8 |
87.0 |
0.203 |
| Oklahoma |
75.6 |
76.0 |
76.9 |
0.555 |
| Rhode Island |
— |
— |
94.8 |
# # |
| South Carolina |
79.8†† |
73.1†† |
80.3†† |
0.762 |
| Utah |
80.8 |
82.0 |
82.8 |
0.271 |
| Vermont |
—f |
85.6f |
84.7 |
# # |
| Washington |
83.0 |
81.2 |
83.3 |
0.907 |
| West Virginia |
86.5 |
87.8 |
85.6 |
0.607 |
Note: Sufficient well-baby care is defined as an infant receiving
2 or more checkups by 2–3 months (60–122 days) of age;
3 or more checkups by 4–5 months (123–183 days) of age; or
4 or more checkups by 6–9 months (184–274 days) of age.
# Based on a test for linear trend using logistic regression.
* p value is less than 0.05.
** p value is less than 0.001.
# # < 3 years of data available; test for linear trend not applicable.
†† Missing ≥ 10% data.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City.
d Data represent Maryland births from February–December 2001.
e Data represent Michigan births from July–December 2001.
f Data represent Vermont births from October 2000–December 2001. |
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Page last reviewed: 5/13/09
Page last modified: 8/23/06
Content source: Division
of Reproductive Health,
National Center for Chronic Disease
Prevention and Health Promotion |
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