Document Detail

Racial disparities in economic and clinical outcomes of pregnancy among Medicaid recipients.
MedLine Citation:
PMID:  23065298     Owner:  NLM     Status:  MEDLINE    
To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hospital and to incur higher Medicaid costs. African-American women were also more likely to experience preeclampsia, placental abruption, preterm birth, small birth size for gestational age, and fetal death/stillbirth. Eliminating racial disparities in adverse pregnancy outcomes (not counting infant costs), could generate Medicaid cost savings of $114 to $214 million per year in these 14 states. Despite having the same insurance coverage and meeting the same poverty guidelines for Medicaid eligibility, African American women have a higher rate of adverse pregnancy outcomes than White or Hispanic women. Racial disparities in adverse pregnancy outcomes not only represent potentially preventable human suffering, but also avoidable economic costs. There is a significant financial return-on-investment opportunity tied to eliminating racial disparities in birth outcomes. With the Affordable Care Act expansion of Medicaid coverage for the year 2014, Medicaid could be powerful public health tool for improving pregnancy outcomes.
Shun Zhang; Kathryn Cardarelli; Ruth Shim; Jiali Ye; Karla L Booker; George Rust
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Maternal and child health journal     Volume:  17     ISSN:  1573-6628     ISO Abbreviation:  Matern Child Health J     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-09-27     Completed Date:  2014-04-14     Revised Date:  2014-10-02    
Medline Journal Info:
Nlm Unique ID:  9715672     Medline TA:  Matern Child Health J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1518-25     Citation Subset:  IM    
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MeSH Terms
African Americans / statistics & numerical data
Cross-Sectional Studies
Delivery, Obstetric / economics*,  statistics & numerical data
Ethnic Groups / statistics & numerical data*
European Continental Ancestry Group / statistics & numerical data
Fetal Death / ethnology
Health Care Costs*
Healthcare Disparities
Hispanic Americans / statistics & numerical data
Infant, Newborn
Length of Stay / economics
Medicaid / economics*,  statistics & numerical data
Pregnancy Outcome / economics,  ethnology*
Premature Birth / ethnology*
Socioeconomic Factors
Statistics, Nonparametric
Stillbirth / ethnology
United States / epidemiology
Young Adult
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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