Teen-focused care versus adult-focused care for the high-risk pregnant adolescent: an outcomes evaluation

Public Health Nurs. Nov-Dec 2001;18(6):424-35. doi: 10.1046/j.1525-1446.2001.00424.x.

Abstract

The purpose of this retrospective, matched-case comparison study was to compare outcomes and cost-effectiveness of comprehensive, interdisciplinary teen-centered prenatal care clinics (Young Women's Clinic & Teen Pregnancy and Parenting Clinic) with "traditional" adult-centered obstetric services (University of Washington Medical Center & Group Health Cooperative) in a university medical center and a staff-model HMO. The sample (n = 106) included 27 index teens from Young Women's Clinic and matched cases from the other three clinics, matched on nine risk variables. Findings showed that teen-clinic clients missed fewer appointments (0.96 vs. 2.29, p < 0.05), were more likely to be enrolled in the supplemental Medicaid program First Steps (p < 0.001) and WIC (p < 0.01), were more likely to have vaginal deliveries (90% vs. 75%, p < 0.05) and higher birth weight infants (3330 vs. 3084 g, p < 0.05), and were more likely to attend 2-week (p < 0.001) and 6-week postpartum exams (p < 0.05). Postpartum data were missing for the majority of adult-clinic subjects; teen-clinic postpartum outcomes included high contraception rates (87.5%), breastfeeding (62%), school return postpartum (63%), and long-term follow-up. Costs were lower for teen clinics based on outcomes; cost savings related to preterm labor were similar.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cost-Benefit Analysis
  • Demography
  • Female
  • Health Maintenance Organizations
  • Health Services Research
  • Hospitals, University
  • Humans
  • Male
  • Outcome Assessment, Health Care*
  • Patient-Centered Care / economics
  • Patient-Centered Care / methods*
  • Pregnancy
  • Pregnancy in Adolescence*
  • Pregnancy, High-Risk*
  • Prenatal Care / organization & administration*
  • Program Evaluation
  • Retrospective Studies