{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:37:30Z","timestamp":1772987850948,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and validate a hierarchical algorithm for assigning prenatal care (PNC) encounters using claims data while ensuring continuity of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting and Design<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study among South Carolina Medicaid beneficiaries. Using a six\u2010step hierarchical algorithm\u2014incorporating specialty designations, diagnostic\/procedure codes, and adjustments for inpatient stays and supplemental visits\u2014we assigned PNC encounters and identified predominant PNC providers. To assess predictive validity, we examined associations between predominant provider status and adverse birth outcomes (obtained from linked birth certificates and claims data) using logit\u2010binomial generalized estimating equations with robust standard errors, and we compared models' performance using both model fit statistics and 10\u2010fold cross\u2010validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample<\/jats:title>\n                    <jats:p>We used South Carolina Medicaid data on live\u2010birth pregnancies from 2016 to 2021. We followed participants from conception until delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>Initial screening identified 302 package\/bundle payment claims, leading to the exclusion of 299 pregnancies (0.3%) from further analysis. The final analytic dataset contained 1,072,615 confirmed PNC encounters for 90,581 (97%) pregnancies. This study identified predominant providers for 87,573 pregnancies (98% of cases with at least two PNC encounters). The analysis of predictive validity revealed significant protective associations for two outcomes when comparing pregnancies with versus without predominant providers: preterm birth (adjusted RR: 0.68, 95% CI: 0.59\u20130.77) and low\u2010birth\u2010weight (adjusted RR: 0.68, 95% CI: 0.57\u20130.80).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study developed and validated a claims\u2010based algorithm to identify PNC utilization in South Carolina Medicaid data. Predictive validity tests revealed that predominant provider status was associated with reduced adverse birth outcomes, suggesting care continuity may improve perinatal health. Future research could apply this algorithm to examine causal relationships between predominant provider status and specific outcomes (e.g., preterm birth, low birth weight), while accounting for institutional and socioeconomic confounders. These findings offer a foundation for optimizing PNC delivery through continuity\u2010focused interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.70063","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T01:10:39Z","timestamp":1761700239000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of an Algorithm to Identify Prenatal Care in Administrative Data: Predictive Validity for Adverse Birth Outcomes"],"prefix":"10.1111","volume":"61","author":[{"given":"Songyuan","family":"Deng","sequence":"first","affiliation":[{"name":"South Carolina Center for Rural and Primary Healthcare University of South Carolina School of Medicine Columbia South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Barabell","sequence":"additional","affiliation":[{"name":"Clear Bell Solutions Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Bennett","sequence":"additional","affiliation":[{"name":"South Carolina Center for Rural and Primary Healthcare University of South Carolina School of Medicine Columbia South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2024.104273"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X16677403"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995\u2010021\u201003236\u2010x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2022.101322"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0250947"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12547"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000709"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2016.04.026"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010024\u201011080\u20102"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410120089033"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.09.038"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S269400"},{"key":"e_1_2_10_14_1","volume-title":"South Carolina Vital and Morbidity Statistics 2022. Volume I Annual Vital Statistics Series Vital Statistics","author":"South Carolina","year":"2024"},{"key":"e_1_2_10_15_1","volume-title":"2025 Legislative Brief","author":"South Carolina Maternal Morbidity and Mortality Review Committee","year":"2025"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0284893"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029\u20107844(02)02024\u20100"},{"key":"e_1_2_10_18_1","unstructured":"The American College of Obstetricians and Gynecologists \u201cCesarean Birth \u201d April 11 2025 accessed April 10 2025 https:\/\/www.acog.org\/womens\u2010health\/faqs\/cesarean\u2010birth."},{"key":"e_1_2_10_19_1","volume-title":"Severe Maternal Morbidity in the United States","author":"Centers for Disease Control and Prevention","year":"2022"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004022"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40471\u2010023\u201000341\u2010z"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558705285294"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.23"},{"key":"e_1_2_10_24_1","volume-title":"Basic ICD\u201010\u2010CM and ICD\u201010\u2010PCS Coding","author":"Palkie B.","year":"2024"},{"key":"e_1_2_10_25_1","volume-title":"ICD\u201010\u2010PCS Official Guidelines for Coding and Reporting, FY 2025","author":"Centers for Medicare & Medicaid Services, National Center for Health Statistics","year":"2024"},{"key":"e_1_2_10_26_1","volume-title":"HCPCS 2025 Level II Professional Edition","author":"American Medical Association","year":"2025"},{"key":"e_1_2_10_27_1","volume-title":"CPT Professional Edition 2025","author":"American Medical Association","year":"2024"},{"key":"e_1_2_10_28_1","volume-title":"Current Procedural Terminology and HCPCS Coding for Physicians and Facilities Exercises","author":"K. 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