Article
Utilisation of prenatal diagnostics during pregnancy in Germany: cross-sectional study using data from the KUNO Kids Health Study
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Published: | September 27, 2021 |
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Background and status of (inter)national research: Appropriate health system utilisation during pregnancy is fundamental, thereby maintaining maternal and child’s health.
Question and objective: This study aims at describing supplementary prenatal diagnostics use and its influencing factors among pregnant women in Germany.
Method or hypothesis: We obtained data from a German birth cohort study, the KUNO Kids Health Study, with a study sample of 1,886 participating mothers. Analyses are based on Andersen’s Behavioural Model of health system use which distinguishes between predisposing, enabling and need factors. We examined the bi- and multivariate association with the use of supplementary prenatal diagnostics using logistic regression analyses
Results: One fifth of the mothers investigated did not use any supplementary prenatal diagnostics. The present study identified the importance of the type of health insurance. Notably, the chance of using supplementary prenatal diagnostics more than doubled if the pregnant woman had a private health insurance. Moreover, maternal age and smoking behaviour played a considerable role. However, regarding need factors only having a risk pregnancy showed an independent association with the utilisation of supplementary diagnostics during pregnancy.
Discussion: Although a shift in the importance of need factors towards enabling factors for preventive health services has been described before, the important role of the type of health insurance and the relatively small association with need factors was surprising.
Practical implications: Diagnostics beyond routine health check ups during pregnancy differ in necessity and usefulness; therefore comprehensive information should be provided to pregnant women.
Appeal for practice (science and/or care) in one sentence: Our finding that private health insurance was associated with higher use of supplementary prenatal diagnostics needs further attention, especially with respect to equity in accessing health care.