Postpartum health care receipt among immigrant women in the United States

美国移民妇女的产后医疗保健收据

• 批准号: 10373538
• 负责人: Maria Ward Steenland
• 金额: $ 22.42万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-11 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10373538
• 关键词: Affect; American College of Obstetricians and Gynecologists; Automobile Driving; Birth; Birth Certificates; Birth Place; Breast Feeding; Child; Child Health; Childbirth; Contraceptive Usage; Contraceptive methods; Counseling; Country; Data; Data Linkages; Data Set; Data Sources; Databases; Eligibility Determination; Emergency Situation; Geographic state; Goals; Health; Health Care Costs; Health Insurance; Health behavior; Healthcare; Immigrant; Immigration; Insurance Coverage; Legal; Link; Live Birth; Low income; Maternal Health; Medicaid; Modeling; Monitor; Mothers; Outcome; Outcome Study; Policies; Policy Maker; Population; Postpartum Period; Postpartum Women; Pregnancy; Prenatal care; Public Health; Public Policy; Records; Research; Risk Assessment; Services; Surveys; System; Testing; United States; Variant; Woman; Women' s Health; care outcomes; cost; disparity reduction; experience; health disparity; neglect; novel; postpartum care; postpartum health; postpartum outcome; pregnant; prevent; programs; residence; unborn child

PROJECT SUMMARY The postpartum period, defined as the three months after childbirth, is a critical and often neglected period for maternal health. Routine postpartum health care, including testing for common postpartum health conditions and counseling on breastfeeding and contraception, is recommended by the American College of Obstetricians and Gynecologists for all postpartum women. Medicaid coverage during pregnancy, which pays for the health care costs associated with forty three percent of births in the United States, covers women for at least 60 days after childbirth. While the majority of low-income women qualify for Medicaid during pregnancy, most states limit eligibility to citizens or lawfully residing immigrants with greater than five years of legal residence. States offer a patchwork of alternative public coverage options, such as Emergency Medicaid, to cover the cost of labor and delivery for women who are not eligible for traditional Medicaid coverage because of their immigration status. Unlike traditional Medicaid, these coverage alternatives often do not cover health care during the postpartum period. Little is currently known about what specific services are covered under alterative public coverage options for childbirth in each state, and how this may affect postpartum outcomes among immigrant women. This research has four aims: In Aim 1, we will create the first database linking data from the Pregnancy Risk Assessment Monitoring System (PRAMS) with information on maternal place of birth from birth certificate records. In Aim 2, we will document state variation in public coverage policies for immigrant women during pregnancy in PRAMS states (including undocumented women and legally residing non-citizens) Aim 3 will use the data compiled in Aim 1 to compare postpartum health care use (including contraceptive use), health outcomes and health behaviors between women born within and outside the U.S. Aim 4 will use the dataset created in Aim 1, and the policy information compiled in Aim 2, to examine the association between state policies for public coverage of immigrant women during and after pregnancy and disparities in postpartum care utilization, health outcomes and health behaviors between postpartum women born within and outside of the US This project will be the first study to examine the association between maternal place of birth and postpartum care receipt, and the first to examine the relationship between state public coverage for immigrant women during pregnancy and postpartum care in this population. The results of this study will provide information to public health practitioners and policy makers about whether there are disparities in health care use after pregnancy between immigrant women and women born in the United States. Further, this study will contribute to our understanding of the relationship between state insurance coverage policies for pregnant and postpartum immigrant women and postpartum health care use.

项目摘要 产后定义为分娩后三个月，是一个关键的且经常被忽视的时期 孕产妇健康。常规的产后医疗保健，包括测试普通产后健康状况 美国产科学院建议进行母乳喂养和避孕的咨询 和所有产后妇女的妇科医生。怀孕期间的医疗补助覆盖范围为健康支付 美国43％的分娩相关的护理费用至少覆盖女性60天 分娩后。虽然大多数低收入妇女在怀孕期间有资格获得医疗补助，但大多数州 限制对公民的资格或合法居住在法律居住五年以上的移民。国家 提供替代公共承保选项（例如紧急医疗补助）的拼凑而成，以支付 由于她们的劳动和分娩 移民身份。与传统的医疗补助不同，这些覆盖范围替代方案通常不涵盖医疗保健 在产后期间。目前，关于哪些特定服务涵盖了哪些特定服务 在每个州的分娩的更改公共承保范围，以及这可能会影响产后结果 在移民妇女中。这项研究有四个目标： 在AIM 1中，我们将创建第一个链接怀孕风险评估监测系统数据的数据库 （婴儿车）提供有关出生证明记录出生地的信息。 在AIM 2中，我们将记录在怀孕期间移民妇女公共承保政策的状态变化 婴儿车（包括无证件的妇女和合法居住的非公民） AIM 3将使用AIM 1中编译的数据比较产后医疗保健使用（包括避孕药 使用），美国内外出生的妇女之间的健康状况和健康行为 AIM 4将使用AIM 1中创建的数据集，以及在AIM 2中汇编的策略信息来检查 在怀孕期间和 产后护理利用，健康结果和产后妇女健康行为的差异 出生于美国内外 该项目将是第一个研究出生地与产后之间关联的研究 护理收据，也是第一个研究国家公共报道对移民妇女的关系的关系 在怀孕期间和产后护理。这项研究的结果将向 公共卫生从业人员和政策制定者关于医疗保健使用差异之后是否存在差异 在美国出生的移民妇女与妇女之间的怀孕。此外，这项研究将有助于 为了理解孕妇的国家保险保险政策之间的关系 产后移民妇女和产后医疗保健。