Socioeconomic, Racial, and Ethnic Disparities in Postpartum Readmissions in Patients with Preeclampsia: a Multi-state Analysis, 2007–2014
Socioeconomic, Racial, and Ethnic Disparities in Postpartum Readmissions in Patients with Preeclampsia: a Multi-state Analysis, 2007–2014
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先兆子痫患者产后再入院的社会经济、种族和民族差异：2007-2014 年多州分析
DOI：
10.1007/s40615-019-00580-1
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发表时间：
2019
影响因子：
3.9
通讯作者：
J. Pick
中科院分区：
文献类型：
--
作者：
J. L. Wagner;R. White;V. Tangel;Soham Gupta;J. Pick
分娩是育龄妇女住院的最常见原因，全国每年约有400万例分娩。高血压是产后再入院的主要指征，因此患有先兆子痫的妇女再入院的风险很高。健康的社会决定因素与产后患者的再入院率增加有关;然而，没有研究专门调查这一高危患者群体的再入院率。我们试图评估产后再入院的所有产后患者和那些诊断为先兆子痫的亚组分析中的社会健康决定因素的影响。MethodsWe进行了回顾性（2007-2014）分析所有单胎分娩在佛罗里达，加州，纽约，和马里兰州从国家住院病人数据库，医疗保健费用和利用项目。主要结局为分娩后30天再次入院。计算描述性统计量，并使用多变量回归分析来估计再入院的校正比值比（OR）。仅对先兆子痫患者进行亚组分析。统计学显著性在< 0.05 α level.ResultsA共4，999，993例患者被纳入我们的分析。在所有的产后患者和子组分析先兆子痫患者，再入院率较高的黑人患者，最贫穷的四分位数的中位数收入的患者，和患者与公共保险（医疗保险或医疗补助）conclusionsThe本研究表明，社会经济和种族/民族的差异存在于产后再入院。这些发现也存在于已经最高风险的先兆子痫患者中。未来的研究应进一步阐明这种关系，并制定改善策略。
PurposeChildbirth is the most common reason for hospitalization for reproductive-aged women, with about 4 million annual deliveries nationally. Hypertension is the leading indication for postpartum readmission and therefore women with preeclampsia are at high risk for readmission. Social determinants of health are associated with increased readmission in postpartum patients; however, no study has specifically investigated readmissions in this higher risk group of patients. We sought to evaluate the effect of social determinants of health on postpartum readmissions in all postpartum patients and in a subgroup analysis of those with a diagnosis of preeclampsia.MethodsWe conducted a retrospective (2007–2014) analysis of all singleton deliveries in Florida, California, New York, and Maryland from the State Inpatient Databases, Healthcare Cost and Utilization Project. Primary outcomes were readmission at 30 days after delivery. Descriptive statistics were calculated, and multivariate regression analysis was used to estimate the adjusted odds ratio (OR) for readmissions. Subgroup analysis was performed on preeclampsia patients only. Statistical significance was evaluated at the < 0.05 alpha level.ResultsA total of 4,999,993 patients were included in our analysis. Among all postpartum patients and in subgroup analysis for preeclampsia patients only, readmission rates are higher for black patients, patients in the poorest quartile of median income, and patients with public insurance (Medicare or Medicaid).ConclusionsThe present study has shown that socioeconomic and racial/ethnic disparities exist in postpartum readmissions. These findings additionally exist among the already highest-risk preeclamptic patients. Future research should further elucidate this relationship and develop amelioration strategies.
影响因子：
7.2
作者：
Sundermann,AlexandraC;Rebeiro,PeterF
通讯作者：
Rebeiro,PeterF
影响因子：
120.7
作者：
Joynt, Karen E.;Orav, E. John;Jha, Ashish K.
通讯作者：
Jha, Ashish K.