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 Steenland博士的长期职业目标是成为独立的政策研究人员，为 改善美国的孕产妇健康。非洲裔美国妇女比白人女性更有可能体验 严重的母亲发病率和死亡率。由于医疗补助涵盖了非洲的不成比例 该计划在怀孕期间，美国和西班牙裔妇女在其物物健康中起着至关重要的作用。 但是，许多在怀孕期间被医疗补助覆盖的妇女在产后60天失去覆盖范围。我们 政策制定者正在考虑减少孕产妇死亡的分配的政策选择，包括扩展 医疗补助妊娠覆盖范围从60天到产后一年。但是，增加的影响 在产后医疗保健使用和健康状况上的医疗补助覆盖范围尚不清楚。 Steenland Will博士 检查医疗补助扩展在分销中的作用在产后保险，医疗保健方面的作用， 以及最近孕妇的健康状况。她将使用美国社区的数据 调查和阿肯色州所有付款人声称数据库购买以下研究的目的：（1）评估 医疗补助扩张对全国产后保险范围中种族/族裔分配的影响； （2） 检查医疗补助扩张对产后护理和健康状况分配的影响 阿肯色州的非裔美国人和非西班牙裔白人妇女，该州在产后收益最大 医疗补助扩展后的保险范围。这些研究将为美国政策提供急需的证据 制造商谈到增加产后保险对医疗保健利用和结果的影响。 拟议的研究是基于Steenland博士先前关于医疗补助报销影响的研究 为产后立即进行产后可逆的避孕避孕和出生 间隔。她将追求以下K01培训旨在为拟议的研究和她做好准备 职业目标：（1）获得妇产科和孕产妇健康的培训； （2）接受家庭健康培训 政策; （3）获得卫生政策评估经济方法的高级培训。实现这些 培训目标，斯蒂恩兰博士已在布朗大学组建了一支导师，由阿马尔·特里维迪（Amal Trivedi）博士领导， 公共卫生学院卫生服务，政策和实践教授；艾拉·威尔逊博士， 卫生服务，政策和实践系教授兼主席； David Savitz博士，教授 公共卫生学院流行病学系；克里斯汀·马特森（Kristen Matteson）博士，副教授 妇产科和妇产系的妇产科和妇产科和安娜·艾泽（Anna Aizer）博士，教授 和经济部主席。 Steenland博士的培训将使她为长期做好准备 成为一名独立调查员的职业目标，致力于减少分销并​​改善产妇 通过健康政策研究健康。