Postpartum Medicaid Eligibility Expansions and Postpartum Health Measures.
Postpartum Medicaid Eligibility Expansions and Postpartum Health Measures.
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产后医疗补助资格扩大和产后健康措施。
DOI：
10.1089/pop.2022.0183
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发表时间：
2023
影响因子：
2.5
通讯作者：
Margerison,Claire
中科院分区：
文献类型：
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作者：
Hettinger,Katlyn;Margerison,Claire
与类似国家相比，美国的孕产妇死亡率和发病率较高，并且存在种族/民族差异，其中许多事件发生在产后后期。拟议的联邦和最近颁布的州政策干预措施将怀孕医疗补助从覆盖60天延长到产后一整年。这项研究估计在产后后期保持医疗补助资格（相对于只有怀孕医疗补助资格）与产后检查出勤率和抑郁症状之间的关联，使用回归分析，总体和按种族/民族分层。有产后医疗补助资格的人参加产后检查的可能性比只有怀孕医疗补助资格的人高1.0%-1.4%，主要是由西班牙裔产后人群的可能性高3.8%-4.0%驱动。相反，产后医疗补助与黑人产后检查出勤率降低2.2%-2.3%的可能性有关。产后资格也与自我报告的抑郁症状的可能性降低9.7%-11.6%相比，只有妊娠医疗补助资格仅适用于白色产后人群。产后医疗补助资格与产妇保健利用和心理健康的一些改善有关，但种族和民族的差异意味着，不能单独通过保险克服的不公平的系统和结构也可能在产后健康中发挥重要作用。
Maternal mortality and morbidity in the United States are high compared with those in similar countries, and racial/ethnic disparities exist, with many of these events occurring in the later postpartum period. Proposed federal and recently enacted state policy interventions extend pregnancy Medicaid from covering 60 days to a full year postpartum. This study estimates the association between maintaining Medicaid eligibility in the later postpartum period (relative to only having pregnancy Medicaid eligibility) with postpartum checkup attendance and depressive symptoms using regression analysis, overall and stratified by race/ethnicity. People with postpartum Medicaid eligibility were 1.0%–1.4% more likely to attend a postpartum checkup relative to those with only pregnancy Medicaid eligibility overall, primarily driven by a 3.8%–4.0% higher likelihood among Hispanic postpartum people. Conversely, postpartum Medicaid is associated with a 2.2%–2.3% lower likelihood of postpartum checkup attendance for Black postpartum people. Postpartum eligibility is also associated with a 9.7%–11.6% lower likelihood of self-reported depressive symptoms compared with only pregnancy Medicaid eligibility for White postpartum people only. Postpartum Medicaid eligibility is associated with some improvements in maternal health care utilization and mental health, but differences by race and ethnicity imply that inequitable systems and structures that cannot be overcome by insurance alone may also play an important role in postpartum health.