Reducing Postpartum Health Care Disparities through Increased Insurance Coverage after Childbirth

通过增加产后保险覆盖范围来减少产后医疗保健差异

• 批准号: 10480811
• 负责人: Maria Ward Steenland
• 金额: $ 14.56万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10480811
• 关键词: Reducing; Postpartum; Health; Care; Disparities

PROJECT SUMMARY Dr. Steenland’s long-term career goal is to become an independent policy researcher generating evidence to improve maternal health in the US. African American women are more likely than white women to experience severe maternal morbidity and mortality. As Medicaid covers a disproportionally large share of African American and Hispanic women during pregnancy, the program plays a critical role in their maternal health. However, many women covered by Medicaid during pregnancy lose coverage at 60 days postpartum. US policy makers are considering policy options to reduce disparities in maternal mortality, including extending Medicaid pregnancy coverage from 60 days to one year postpartum. However, the effect of increased Medicaid coverage on postpartum health care use and health outcomes is not known. Dr. Steenland will examine the role of Medicaid expansion on disparities in postpartum insurance coverage, health care access, and health outcomes among recently pregnant women. She will use data from the American Community Survey and the Arkansas All-Payers Claims Database to pursue the following research aims: (1) Evaluate the effect of Medicaid expansion on racial/ethnic disparities in postpartum insurance coverage nationally; (2) Examine the effect of Medicaid expansion on disparities in postpartum care and health outcomes between African American and non-Hispanic white women in Arkansas, the state with the largest gains in postpartum insurance coverage after Medicaid expansion. These studies will provide much needed evidence to US policy makers about the effect of increased postpartum insurance coverage on health care utilization and outcomes. The proposed research builds upon Dr. Steenland’s prior research on the effects of Medicaid reimbursement for immediate postpartum long-acting reversible contraception on postpartum contraceptive use and birth intervals. She will pursue the following K01 training aims to prepare her for the proposed research and for her career goals: (1) Acquire training in obstetrics and maternal health; (2) Acquire training in domestic health policy; (3) Acquire advanced training in econometric methods for health policy evaluation. To achieve these training goals, Dr. Steenland has assembled a team of mentors at Brown University, led by Dr. Amal Trivedi, Professor in the School of Public Health’s Department of Health Services, Policy, and Practice; Dr. Ira Wilson, Professor and Chair of the Department of Health Services, Policy, and Practice; Dr. David Savitz, Professor in the Department of Epidemiology in the School of Public Health; Dr. Kristen Matteson, Associate Professor of Obstetrics and Gynecology in the Department of Obstetrics and Gynecology and Dr. Anna Aizer, Professor and Chair of the Department of Economics. Dr. Steenland’s training will prepare her to achieve her long-term career goal of becoming an independent investigator working to reduce disparities and improve maternal health through health policy research.

项目概要 Steenland 博士的长期职业目标是成为一名独立的政策研究员，为以下方面提供证据： 改善美国的孕产妇健康。非裔美国女性比白人女性更有可能经历 孕产妇发病率和死亡率严重。由于医疗补助覆盖了非洲大部分人口 美国和西班牙裔妇女在怀孕期间，该计划对其孕产妇健康起着至关重要的作用。 然而，许多怀孕期间享受医疗补助的女性在产后 60 天后就失去了承保范围。我们 政策制定者正在考虑缩小孕产妇死亡率差异的政策选择，包括延长 医疗补助怀孕承保范围为产后 60 天至一年。不过增加的效果 医疗补助对产后医疗保健使用和健康结果的覆盖范围尚不清楚。斯廷兰博士将 研究医疗补助扩大对产后保险覆盖范围、医疗保健获取、 以及最近怀孕妇女的健康结果。她将使用来自美国社区的数据 调查和阿肯色州所有付款人索赔数据库旨在实现以下研究目标：(1) 评估 医疗补助扩大对全国产后保险覆盖面的种族/民族差异的影响； (2) 检查医疗补助扩大对产后护理和健康结果差异的影响 阿肯色州的非裔美国和非西班牙裔白人妇女是产后增长最大的州 医疗补助扩大后的保险范围。这些研究将为美国政策提供急需的证据 制造商了解增加产后保险覆盖范围对医疗保健利用和结果的影响。 拟议的研究建立在 Steenland 博士之前关于医疗补助报销影响的研究的基础上 用于产后立即长效可逆避孕，用于产后避孕药的使用和分娩 间隔。她将进行以下 K01 培训目标，为拟议的研究和她的工作做好准备 职业目标： (1) 获得产科和孕产妇保健方面的培训； (2) 接受家庭卫生培训 政策; (3) 获得卫生政策评估计量经济学方法的高级培训。为了实现这些 为了实现培训目标，Steenland 博士在布朗大学组建了一支由 Amal Trivedi 博士领导的导师团队， 公共卫生学院卫生服务、政策和实践系教授；艾拉·威尔逊博士， 卫生服务、政策和实践系教授兼系主任；大卫·萨维茨博士，教授 公共卫生学院流行病学系；克里斯汀·马特森博士，副教授 妇产科妇产科和Anna Aizer博士，教授 兼经济系系主任。 Steenland 博士的培训将为她实现长期目标做好准备 成为一名独立调查员的职业目标，致力于减少差异并改善孕产妇状况 通过卫生政策研究实现健康。