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Postpartum Emergency Department Visits and Inpatient Readmissions in a Medicaid Population of Mothers.

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Bibliographic Details
Title: Postpartum Emergency Department Visits and Inpatient Readmissions in a Medicaid Population of Mothers.
Authors: Ehrenthal, Deborah B., Gelinas, Katie, Paul, David A., Agiro, Abiy, Denemark, Cynthia, Brazen III, Anthony J., Pollack, Michael, Hoffman, Matthew K.
Source: Journal of Women's Health (15409996). Sep2017, Vol. 26 Issue 9, p984-991. 8p.
Subjects: Hospital emergency services, Longitudinal method, Medicaid, Multivariate analysis, Obstetrics, Postnatal care, Logistic regression analysis, Retrospective studies, Patient readmissions
Geographic Terms: Atlantic Coast (Middle Atlantic States), Middle Atlantic States
Abstract: Background: Little comprehensive literature exists to broadly examine risk factors for emergency department (ED) utilization or inpatient admission after obstetrical delivery. Materials and Methods: We conducted a retrospective cohort study of Medicaid-insured women from 2009 to 2012 who delivered at a regional perinatal center in the Mid-Atlantic. Women were included if Medicaid was the primary payer of record for the delivery and there was continuous 9-month predelivery Medicaid eligibility. Electronic obstetrical data were linked to Medicaid claims for 9-month prenatal and 6-month postpartum care following delivery. Negative binomial regression was used to examine factors associated with an ED visit; multivariable logistic regression was used to examine factors associated with hospital admission. Results: Following 4484 births, 1564 (34.9%) mothers had an ED visit, and 298 (6.6%) a hospital admission, within 6 months of delivery. Mother's race was significantly associated with both ED visits and inpatient admissions, whereas age and marital status were associated with ED use. Medical comorbidities, tobacco and substance use, cesarean delivery, and severe obstetrical morbidity were associated with both ED visits and hospital admission. In addition, both prenatal opioid use and bipolar disorder increased the odds of ED use and hospital admission. Conclusions: Medical, social, and behavioral characteristics of women, as well as cesarean delivery, were associated with increased medical utilization in the postpartum. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Background: Little comprehensive literature exists to broadly examine risk factors for emergency department (ED) utilization or inpatient admission after obstetrical delivery. Materials and Methods: We conducted a retrospective cohort study of Medicaid-insured women from 2009 to 2012 who delivered at a regional perinatal center in the Mid-Atlantic. Women were included if Medicaid was the primary payer of record for the delivery and there was continuous 9-month predelivery Medicaid eligibility. Electronic obstetrical data were linked to Medicaid claims for 9-month prenatal and 6-month postpartum care following delivery. Negative binomial regression was used to examine factors associated with an ED visit; multivariable logistic regression was used to examine factors associated with hospital admission. Results: Following 4484 births, 1564 (34.9%) mothers had an ED visit, and 298 (6.6%) a hospital admission, within 6 months of delivery. Mother's race was significantly associated with both ED visits and inpatient admissions, whereas age and marital status were associated with ED use. Medical comorbidities, tobacco and substance use, cesarean delivery, and severe obstetrical morbidity were associated with both ED visits and hospital admission. In addition, both prenatal opioid use and bipolar disorder increased the odds of ED use and hospital admission. Conclusions: Medical, social, and behavioral characteristics of women, as well as cesarean delivery, were associated with increased medical utilization in the postpartum. [ABSTRACT FROM AUTHOR]
ISSN:15409996
DOI:10.1089/jwh.2016.6180