Utilisation of supplementary prenatal screening and diagnostics in Germany: cross-sectional study using data from the KUNO Kids Health Study.
Andersen’s Behavioural Model of Health Services Use
Birth cohort
Supplementary prenatal screening and diagnostics
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
24 May 2022
24 May 2022
Historique:
received:
29
06
2021
accepted:
14
04
2022
entrez:
24
5
2022
pubmed:
25
5
2022
medline:
27
5
2022
Statut:
epublish
Résumé
Appropriate health system utilisation during pregnancy is fundamental for maintaining maternal and child's health. To study the use and determinants of supplementary prenatal screening and diagnostics in Germany this study provides comprehensive data. We obtained data from a recently established prospective German birth cohort study, the KUNO Kids Health Study. Analyses are based on Andersen's Behavioural Model of health system use, which distinguishes between predisposing (e.g. country of birth), enabling (e.g. health insurance) and need factors (e.g. at-risk pregnancy). We examined bi- and multivariate association with the use of supplementary prenatal screening and diagnostics using logistic regression. The study has a sample size of 1886 participating mothers. One fifth of the mothers investigated did not use any supplementary prenatal screening or diagnostics. Notably, the chance of using supplementary prenatal screening and diagnostics more than doubled if the pregnant woman had a private health insurance (OR 2.336; 95% CI 1.527-3.573). Higher maternal age (OR 1.038; 95% CI 1.006-1.071) and environmental tobacco smoke exposure (OR 1.465 95% CI 1.071-2.004) increased the use of supplementary prenatal screening and diagnostics. However, regarding need factors only having an at-risk-pregnancy (OR 1.688; 95% CI 1.271-2.241) showed an independent association. The important role of the type of health insurance and the relatively small influence of need factors was surprising. Especially with respect to equity in accessing health care, this needs further attention.
Sections du résumé
BACKGROUND
BACKGROUND
Appropriate health system utilisation during pregnancy is fundamental for maintaining maternal and child's health. To study the use and determinants of supplementary prenatal screening and diagnostics in Germany this study provides comprehensive data.
METHODS
METHODS
We obtained data from a recently established prospective German birth cohort study, the KUNO Kids Health Study. Analyses are based on Andersen's Behavioural Model of health system use, which distinguishes between predisposing (e.g. country of birth), enabling (e.g. health insurance) and need factors (e.g. at-risk pregnancy). We examined bi- and multivariate association with the use of supplementary prenatal screening and diagnostics using logistic regression.
RESULTS
RESULTS
The study has a sample size of 1886 participating mothers. One fifth of the mothers investigated did not use any supplementary prenatal screening or diagnostics. Notably, the chance of using supplementary prenatal screening and diagnostics more than doubled if the pregnant woman had a private health insurance (OR 2.336; 95% CI 1.527-3.573). Higher maternal age (OR 1.038; 95% CI 1.006-1.071) and environmental tobacco smoke exposure (OR 1.465 95% CI 1.071-2.004) increased the use of supplementary prenatal screening and diagnostics. However, regarding need factors only having an at-risk-pregnancy (OR 1.688; 95% CI 1.271-2.241) showed an independent association.
CONCLUSION
CONCLUSIONS
The important role of the type of health insurance and the relatively small influence of need factors was surprising. Especially with respect to equity in accessing health care, this needs further attention.
Identifiants
pubmed: 35610584
doi: 10.1186/s12884-022-04692-1
pii: 10.1186/s12884-022-04692-1
pmc: PMC9131677
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
436Subventions
Organisme : research grants of the EU
ID : (HEALS: 603946)
Organisme : research grants of the EU
ID : (HEALS: 603946)
Organisme : research grants of the EU
ID : (HEALS: 603946)
Organisme : research grants of the EU
ID : (HEALS: 603946)
Organisme : research grants of the EU
ID : (HEALS: 603946)
Organisme : research grants of the EU
ID : (HEALS: 603946)
Organisme : research grants of the EU
ID : (HEALS: 603946)
Organisme : research grants of the EU
ID : (HEALS: 603946)
Organisme : research grants of the EU
ID : (HEALS: 603946)
Investigateurs
Petra Arndt
(P)
Andrea Baessler
(A)
Mark Berneburg
(M)
Stephan Böse-O'Reilly
(S)
Romuald Brunner
(R)
Wolfgang Buchalla
(W)
Sara Fill Malfertheiner
(SF)
Andre Franke
(A)
Sebastian Häusler
(S)
Iris Heid
(I)
Caroline Herr
(C)
Wolfgang Högler
(W)
Sebastian Kerzel
(S)
Michael Koller
(M)
Michael Leitzmann
(M)
David Rothfuß
(D)
Wolfgang Rösch
(W)
Bianca Schaub
(B)
Bernhard H F Weber
(BHF)
Stephan Weidinger
(S)
Sven Wellmann
(S)
Informations de copyright
© 2022. The Author(s).
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