RESUMO
OBJECTIVES: This report presents new data from birth certificates on the principal source of payment for the delivery in 2010 for the following groups: private insurance, Medicaid, self-pay (uninsured), and other payment sources. These data are for the 33 states and District of Columbia that adopted the 2003 U.S. Standard Certificate of Live Birth by January 2010, representing 76% of all 2010 U.S. births. Trend data for the United States for 1990-2010 are also presented from the Centers for Disease Control and Prevention's National Center for Health Statistics, National Hospital Discharge Survey (NHDS), to provide a national comparison and historical context. METHODS: Tabular and graphical data on deliveries by the principal source of payment for 2010 from the birth certificate are compared with NHDS estimates. Trend data for 1990-2010 from NHDS are also presented. Detailed data from the birth certificate on maternal characteristics, prenatal care receipt, and cesarean delivery are provided. RESULTS: Private insurance was the most frequent payment source for deliveries in the birth certificate-revised reporting area in 2010 (45.8% of births), followed closely by Medicaid (44.9%), ''other'' payment sources (5.0%), and self-pay (4.4%). Similarly, NHDS data show that private insurance was the most common payment source for deliveries nationally in 2010, followed by Medicaid. Privately insured deliveries declined over the last decade, while the use of Medicaid insurance increased. Medicaid insurance of deliveries was highest for births to teenagers and for non-Hispanic black and Hispanic mothers, according to the birth certificate data. Privately insured mothers were most likely of all payment groups to receive early prenatal care and to have cesarean deliveries.
