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: 10259761
• 负责人: Maria Ward Steenland
• 金额: $ 14.84万
• 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/10259761
• 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.

项目摘要 博士Steenland的长期职业目标是成为一名独立的政策研究员，为 改善美国的产妇健康。非裔美国女性比白色女性更容易经历 产妇发病率和死亡率很高。由于医疗补助覆盖的非洲人比例过高， 美国和西班牙裔妇女在怀孕期间，该计划发挥了关键作用，在他们的孕产妇健康。 然而，许多在怀孕期间享受医疗补助的妇女在产后60天失去了医疗保险。美国 决策者正在考虑各种政策选择，以缩小产妇死亡率的差距，包括扩大产妇死亡率。 Medicaid妊娠保险范围为产后60天至1年。但是，效果的增加 医疗补助对产后保健使用和健康结果的覆盖率尚不清楚。斯蒂恩兰医生会 研究医疗补助的扩大对产后保险覆盖率、医疗保健机会 和健康结果的影响。她将使用美国社区的数据 调查和阿肯色州所有付款人索赔数据库，以追求以下研究目标：（1）评估 Medicaid扩展对全国产后保险覆盖率中种族/民族差异的影响;（2） 研究医疗补助扩展对产后护理和健康结果差异的影响 阿肯色州的非裔美国人和非西班牙裔白色妇女，该州的产后 医疗补助扩大后的保险覆盖范围。这些研究将为美国的政策提供急需的证据 制造商关于增加产后保险覆盖范围对医疗保健利用和结果的影响。 这项研究建立在Steenland博士之前对医疗补助报销影响的研究的基础上 用于产后即刻长效可逆避孕对产后避孕药使用和分娩的影响 的间隔她将继续进行以下K 01培训，目的是为拟定的研究做好准备，并为她 职业目标：（1）获得产科和孕产妇保健方面的培训;（2）获得家庭保健方面的培训 （3）获得卫生政策评价的计量经济学方法方面的高级培训。实现这些 为了实现培训目标，斯廷兰博士在布朗大学组建了一个导师团队，由阿玛尔·特里维迪博士领导， 公共卫生学院卫生服务、政策和实践系教授;伊拉Wilson博士， 卫生服务、政策和实践系教授兼系主任;大卫Savitz博士， 公共卫生学院流行病学系; Kristen Matteson博士， 妇产科和安娜·艾泽尔博士，教授 和经济系主任。Steenland医生的训练将帮助她实现长期的 职业目标是成为一名独立的调查员，致力于减少差距，改善产妇状况 通过卫生政策研究促进健康。