Purpose

Integrated models of primary care for parenting teens, in which teens and infants are cared for by the same clinical team on the same day, are associated with reduced repeated pregnancies and increased uptake of contraception and immunization. Our purpose was to determine how frequently teen-infant dyads receive integrated care.

Methods

This study used Medicaid Analytic eXtract data to create a retrospective cohort of mothers aged 12-17 linked with infants born from 2007-2012 in 12 states. Teen-infant dyads were enrolled in Medicaid throughout the year after birth. The primary outcome was integrated care in the year after birth, defined as ≥ 1 instance when teen and infant had visits on the same day, billed to the same clinician identifier. Logistic regression assessed the relationship between integrated care and maternal demographics, dyad health, clinician specialty, and community factors.

Results

Of 20,203 dyads, 3,371 (16.7%) had integrated care in the year after birth. Dyads with integrated care had a mean of 1.2 (SD 1.3) integrated visits. Dyads with integrated care had more visits (14.9, SD 10.6 vs. 11.7, SD 8.3), including more preventive visits for teens and more acute visits for both teens and infants. In regression, integrated care was associated with maternal factors (younger age, non-Latinx white race, and maternal health risks), residence in rural or high-poverty areas, and ever visiting Family Medicine clinicians.

Discussion

Though uncommon, integrated care was associated with greater engagement in health care. Implementation of integrated care may support increased preventive care for parenting teens.

中文翻译：

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青少年母亲及其婴儿综合护理的患病率和预测因素

目的

青少年育儿初级保健的综合模式（即青少年和婴儿由同一临床团队在同一天照顾）与减少重复怀孕以及增加避孕和免疫接种的采用有关。我们的目的是确定青少年婴儿二人接受综合护理的频率。

方法

这项研究使用 Medicaid Analytic eXtract 数据创建了 12 个州 12-17 岁母亲与 2007-2012 年出生婴儿的回顾性队列。青少年婴儿夫妇在出生后全年都参加了医疗补助计划。主要结局是出生后一年内的综合护理，定义为青少年和婴儿在同一天就诊的情况≥1 次，并按同一临床医生标识符计费。逻辑回归评估了综合护理与孕产妇人口统计、二人健康、临床医生专业和社区因素之间的关系。

结果

在 20,203 名夫妇中，3,371 名（16.7%）在出生后一年接受了综合护理。接受综合护理的二人平均有 1.2 次（SD 1.3）综合就诊。接受综合护理的二人组的就诊次数更多（14.9，SD 10.6 vs. 11.7，SD 8.3），包括针对青少年的更多预防性就诊以及针对青少年和婴儿的更多急性就诊。在回归中，综合护理与母亲因素（年龄较小、非拉丁裔白人种族和母亲健康风险）、居住在农村或高度贫困地区以及曾经拜访过家庭医学临床医生有关。

讨论

尽管不常见，但综合护理与更多地参与医疗保健有关。实施综合护理可以支持加强对青少年育儿的预防性护理。