Graduate School of Business


Doctor of Business Administration (DBA)


Terrence Duncan


Prenatal Care, Preterm Birth, Preterm Birth Costs, Health Care Costs, Tennessee


Business | Medicine and Health Sciences


Preterm birth contributes significantly to health care costs in the United States (Frey & Klebanoff, 2016). Certain components of prenatal care reduce preterm birth incidence (Newnham et al., 2014). Tennessee’s preterm birth rate ranks 35th among the 50 United States (National Center for Health Statistics, 2019). This study analyzed the investment potential to reduce preterm birth cost through increasing prenatal care utilization in Tennessee. Based on 2018 data, the study identified a significant relationship between prenatal care utilization and preterm birth incidence in Tennessee. The study also identified a significant opportunity to increase prenatal care utilization in Tennessee when compared to Oregon, which is a state with higher prenatal care utilization and lower preterm birth incidence. Although the study did not identify a statistically significant difference between preterm birth costs and term birth costs, it did identify an economically material difference. It is clear from the findings that a material investment opportunity exists to increase prenatal care utilization as a tactic to decrease preterm birth costs in Tennessee. Additional research may determine if at-risk groups produce opportunities for larger investment.