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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedSteenland MW, Wilson IB, Matteson KA
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
This study’s objective was to measure the association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities. A total of 60,990 childbirths were reviewed from January 1, 2014 on with a total of 72.3% paid for by Medicaid and 27.7% paid for by a commercial payer. The mean age of the birthing person was 27; with 67% White, 22% Black, and 7% Hispanic. Medicaid expansion in Arkansas was associated with a 27.8 percentage point increase in continuous insurance coverage and an increase in outpatient visits of 0.9 during the first 6 months postpartum, representing relative increases of 54.9% and 75.0%, respectively. Racial disparities in postpartum coverage decreased from 6.3 percentage points before expansion to -2.0 after. However, disparities in outpatient care after expansion persisted between Black and White individuals.
AHRQ-funded; HS027464.
Citation: Steenland MW, Wilson IB, Matteson KA .
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
JAMA Health Forum 2021 Dec;2(12):e214167. doi: 10.1001/jamahealthforum.2021.4167..
Keywords: Medicaid, Maternal Care, Pregnancy, Racial and Ethnic Minorities, Disparities, Policy, Women, Access to Care
Admon LK, Dalton VK, Kolenic GE
Comparison of delivery-related, early and late postpartum severe maternal morbidity among individuals with commercial insurance in the US, 2016 to 2017.
This study analyzed data from 2016 to 2017 on delivery-related, early, and late postpartum severe maternal morbidity (SMM) among individuals with commercial insurance by race and ethnicity and perinatal mood and anxiety disorder (PMAD) status. This cross-sectional study of deidentified claims data from the Optum Clinformatics Data Mart evaluated rates of SMM during 3 pregnancy periods among individuals aged 15 to 44 years. The study sample comprised of 100,982 individuals with a mean age of 31.6 years. SMM rates were compared for pregnancies with and without complications, with blood transfusions being the number one indicator for pregnancy and postpartum periods with SMM. Rates of SMM with and without blood transfusion varied by race and ethnicity and PMAD status. Higher rates of SMM were identified among Black individuals compared with White individuals for the pregnancy, early postpartum, and late postpartum periods, respectively. Higher rates of blood transfusion were also identified in each of the 3 periods among individuals with PMADs compared to individuals without PMADs.
AHRQ-funded; HS027640.
Citation: Admon LK, Dalton VK, Kolenic GE .
Comparison of delivery-related, early and late postpartum severe maternal morbidity among individuals with commercial insurance in the US, 2016 to 2017.
JAMA Netw Open 2021 Dec;4(12):e2137716. doi: 10.1001/jamanetworkopen.2021.37716..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Pregnancy, Health Insurance, Racial and Ethnic Minorities, Anxiety
Burris HH, Passarella M, Handley SC
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
This study’s objective was to determine whether black-white disparities in maternal in-hospital mortality during delivery vary across hospital types (black-serving vs non-black and teaching vs non-teaching) and whether overall maternal mortality differs across hospital types. The authors performed a population-based, retrospective cohort study of 5,679,044 deliveries among black (14.2%) and white patients (85.8%) in 3 states (California, Missouri, and Pennsylvania) from 1995 to 2009. Examination of black-white disparities found that after risk adjustment, black patients had significantly greater risk of death and that the disparity was similar within each of the hospital types. At teaching hospitals, mortality was similar in black-serving and nonblack-serving hospitals. Among non-teaching hospitals, mortality was significantly higher in black-serving vs nonblack-serving hospitals. Over half (53%) of black patients delivered in nonteaching black-serving hospitals compared with just 19% of white patients.
AHRQ-funded; HS018661.
Citation: Burris HH, Passarella M, Handley SC .
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
Am J Obstet Gynecol 2021 Jul;225(1):83.e1-83.e9. doi: 10.1016/j.ajog.2021.01.004..
Keywords: Maternal Care, Pregnancy, Mortality, Women, Racial and Ethnic Minorities, Disparities, Hospitals
Lange EMS, Toledo P
Peripartum racial/ethnic disparities.
Addressing disparities has been a focus of the US Department of Health and Human Services Healthy People initiative for decades, with the most recent Healthy People 2020 establishing a need for health equity in the United States. In this article, the investigators presented an overview of peripartum racial/ethnic disparities and address potential structural solutions to improve maternal health equity.
AHRQ-funded; HS025267.
Citation: Lange EMS, Toledo P .
Peripartum racial/ethnic disparities.
Int Anesthesiol Clin 2021 Jul 1;59(3):1-7. doi: 10.1097/aia.0000000000000326..
Keywords: Maternal Care, Pregnancy, Disparities, Racial and Ethnic Minorities, Women
Mehra R, Boyd LM, Magriples U
Black pregnant women "get the most judgment": a qualitative study of the experiences of Black women at the intersection of race, gender, and pregnancy.
This qualitative study examined the experiences of Black pregnant women and how being stereotyped can cause stress. Semistructured interviews with 24 Black pregnant women in New Haven, Connecticut was conducted. The women were asked about their experience of being pregnant, experiences of gendered racism, and concerns related to pregnancy and parenting Black children. Many of the women experienced gendered racism stigmatizing Black motherhood that devalued Black pregnancies. They reported encountering assumptions that they were poor, single, and had multiple children regardless of socioeconomic status, marital status, or parity. This pregnancy stigma occurred in everyday, health care, social services, and housing-related contexts. This may contribute to poorer maternal and infant outcomes by way of reduced access to quality health care; impediments to services, resources, and social support; and poorer psychological health. Interventions to combat this problem include anti-bias training for health care and social service providers; screening for racialized pregnancy stigma and providing evidence-based coping strategy; creating pregnancy support groups; and developing broader societal discourse that values Black women and their pregnancies.
AHRQ-funded; HS017589.
Citation: Mehra R, Boyd LM, Magriples U .
Black pregnant women "get the most judgment": a qualitative study of the experiences of Black women at the intersection of race, gender, and pregnancy.
Womens Health Issues 2020 Nov-Dec;30(6):484-92. doi: 10.1016/j.whi.2020.08.001..
Keywords: Pregnancy, Women, Racial and Ethnic Minorities
Glazer KB, Danilack VA, Werner EF
Elucidating the role of overweight and obesity in racial and ethnic disparities in cesarean delivery risk.
This study’s goal was to quantify the extent to which overweight and obesity explain cesarean delivery rates among women of different racial and ethnic backgrounds. Administrative records were used from New York City for 216,481 singleton, nulliparous births from 2008 to 2013. Risk ratios, risk differences, and population attributable fractions for associations between body mass index and cesarean, stratified by race and ethnicity was calculated. Black and Hispanic women had the highest cesarean rates attributable to obesity and overweight (17.4% and 14.6%) respectively.
AHRQ-funded; HS025013.
Citation: Glazer KB, Danilack VA, Werner EF .
Elucidating the role of overweight and obesity in racial and ethnic disparities in cesarean delivery risk.
Ann Epidemiol 2020 Feb;42:4-11.e4. doi: 10.1016/j.annepidem.2019.12.012.
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Keywords: Disparities, Racial and Ethnic Minorities, Pregnancy, Labor and Delivery, Risk, Obesity, Women