What factors make a difference in the delivery of perinatal care? This study seeks to determine the extent to which comprehensiveness, continuity and coordination in the delivery of prenatal care effect maternal and infant morbidity. Prenatal care has been associated with improved health outcomes but major national reports all cite the lack of adequate research on the content of prenatal care. (2,3,9) Past research has focused on maternal risk factors, number of prenatal visits and outcome measures of infant mortality and birthweight. (8-15) This project uses the same sample as a previous study but creates a factorial design with groups of randomly (N=428) and non-randomly (N=613) assigned low income pregnant women who were further subdivided to one of two study sites. The sites represent two divergent approaches to perinatal health services. One approach follows the traditional medical model of specialty care while the second involves a multidisciplinary team approach. Data were collected through patient interview and medical record audit from entry into prenatal care through the child's second birthday. With 11% of the gross national product devoted to health, concern is expressed over increasing the effectiveness of our health care dollars. Analysis based on comprehensiveness, continuity and coordination can help identify the effectiveness of certain approaches and remaining gaps in patient care delivery. Policy makers and program planners on federal and state level will be better informed for the continuing development of maternal and child health programs.
