Authors: Juned Siddique John D Lantos Tyler J VanderWeele Diane S Lauderdale
Publish Date: 2010/11/28
Volume: 16, Issue: 1, Pages: 51-59
Abstract
To examine whether the frequency of four screening tests during prenatal care conforms to evidence of effectiveness We estimated rates of urine culture anemia screening oral glucose tolerance test OGTT and urinalysis during prenatal care To do this we used national probability samples of office visits to physicians National Ambulatory Medical Care Survey and to hospital outpatient departments National Hospital Ambulatory Medical Care Survey from 2001 to 2006 We compare observed rates to recommendations from the US Preventive Services Task Force USPSTF On average women received a urine culture in less than half of pregnancies Women received just over one anemia screening on average per pregnancy From 2001–2003 women received an average of 56 urinalyses per pregnancy the average dropped to 43 urinalyses per pregnancy in 2004–2006 On average women received just under one OGTT per pregnancy Minorities and older women tend to get more anemia screenings urine cultures and OGTTs than white women and younger women Compared to USPSTF recommendations too few women are receiving a urine culture during prenatal care In contrast women receive far too many urinalyses but the rate appears to be falling Anemia screening conforms closely to recommendations The USPSTF does not recommend for or against universal diabetes screening using OGTT Women appear to receive OGTT routinelyHere we describe the details regarding the downweighting of the NAMCS/NHAMCS survey weights to produce estimates at the patient level rather than at the visit level We also describe our method for estimating the average number of procedures per pregnancy and its associated varianceAssume a population with M prenatal visits by N patients Let x j represent a binary visit characteristic of interest eg urinalysis for visit j where j=1ldotsM Define m i as the number of prenatal visits by patient i so that sum i=1Nm i=M
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