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: 10590582
• 负责人: Maria Ward Steenland
• 金额: $ 20.43万
• 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 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10590582
• 关键词: Affect; American College of Obstetricians and Gynecologists; Automobile Driving; Birth; Birth Certificates; Birth Place; Breast Feeding; Caring; Child; Child Health; Childbirth; Contraceptive Usage; Contraceptive methods; Counseling; Country; Data; Data Linkages; Data Set; Data Sources; Databases; Disparity; Eligibility Determination; Emergency Situation; Goals; Health; Health Care Costs; Health Insurance; Health behavior; Health behavior and outcomes; Healthcare; Immigrant; Immigration; Insurance Coverage; Legal; Link; Live Birth; Low income; Maternal Health; Medicaid; Medicaid eligibility; Modeling; Monitor; Mothers; Outcome; Outcome Study; Policies; Policy Maker; Population; Postpartum Period; Postpartum Women; Pregnancy; Public Health; Public Policy; Qualifying; Recommendation; Records; Research; Risk Assessment; Services; Surveys; System; Testing; US State; United States; Variant; Woman; cost; disparity reduction; experience; health care disparity; health disparity; neglect; novel; post pregnancy; 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 产后期，定义为分娩后的三个月，是一个关键的，往往被忽视的时期， 产妇保健。常规产后保健，包括常见产后健康状况的检测 以及母乳喂养和避孕方面的咨询， 以及所有产后妇女的妇科医生。怀孕期间的医疗补助覆盖范围， 在美国，43%的新生儿的护理费用至少覆盖了60天 在分娩后。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 将资格限制在公民或合法居住超过五年的法律的移民。国 提供一系列替代公共保险方案，如紧急医疗补助，以支付 分娩和分娩的妇女谁不符合传统的医疗保险，因为他们的 移民身份与传统的医疗补助不同，这些覆盖范围通常不包括医疗保健 在产后期间。目前，人们对《公约》涵盖哪些具体服务知之甚少。 每个州分娩的替代公共保险选择，以及这可能如何影响产后结果 在移民妇女中。这项研究有四个目标： 在目标1中，我们将创建第一个数据库，链接妊娠风险评估监测系统的数据 （PRAMS），从出生证记录中提供产妇出生地的信息。 在目标2中，我们将记录各州对怀孕期间移民妇女的公共保险政策的变化， PRAMS州（包括无证妇女和合法居住的非公民） 目标3将使用目标1中汇编的数据，比较产后保健使用情况（包括避孕药具 使用），健康结果和健康行为之间的妇女出生在美国境内和境外。 目标4将使用目标1中创建的数据集和目标2中编制的政策信息， 关于移民妇女怀孕期间和怀孕后公共保险的国家政策之间的联系， 产后妇女产后护理利用、健康结果和健康行为的差异 在美国境内和境外出生 该项目将是第一项研究，以检查产妇的出生地点和产后 护理收据，第一次审查国家公共覆盖移民妇女之间的关系， 在这一人群中的怀孕和产后护理期间。这项研究的结果将提供信息， 公共卫生从业人员和政策制定者关于是否有差异，在医疗保健使用后， 移民妇女和在美国出生的妇女之间的怀孕。此外，这项研究将有助于 我们对怀孕和怀孕期间国家保险政策之间关系的理解 产后移民妇女和产后保健利用。