Quality improvement efforts in prenatal care for Oklahoma Medicaid managed care patients: 1995-1998.

: The Oklahoma Health Care Authority and the Oklahoma Foundation for Medical Quality analyzed documented patterns of care in the Oklahoma Medicaid urban managed care plans from 1995 through 1998. In 1995, 31.3% of the patients had started prenatal care in the first trimester, and 50.6% of the patients had first trimester prenatal care in 1998. No prenatal care was noted for 3.2% in 1995, which decreased to 2.9% for 1998. For 1995, 23.9% of the deliveries were operative and 20.8% for 1998. Similarly, the vaginal delivery after previous C-section (VBAC) rate was 36.5% for 1995, and increased to 41.0% in 1998. Very low birth weight (defined as below 1500 grams) rates were 3.7% for 1995 and 1.3% for 1998, while the low birth weight (between 1500 and 2499 grams) infants were recorded for 7.8% of the live births in 1995, and for 1998, 7.5%. While there has been improvement in rates over the four years of the study, opportunities for improvement in the provision of the prenatal care for the Oklahoma Medicaid managed care population remain.