Emergency Room Utilization after Medically Complicated Pregnancies: A Medicaid Claims Analysis

Ashley Harris, Hsien-Yen Chang, Lin Wang, Martha Sylvia, Donna M Neale, David Levine, Wendy Bennett

Research output: Contribution to journalArticle

Abstract

Background: Women with pregnancy complications benefit from closer monitoring postpartum and beyond. Increased postpartum emergency room (ER) use may indicate unmet need for outpatient obstetrics and primary care. The purpose of this study was to evaluate whether women with pregnancy complications (gestational diabetes [GDM], gestational hypertension, and preeclampsia) have increased ER use in the first 6 months postpartum, compared with women without these complications. Methods: We conducted a retrospective population-based cohort study using a 2003-2010 Maryland Medicaid managed care claims data set, linked with U.S. Census data. Data included claims for outpatient and ER visits for women aged 12-45 years who were continuously enrolled in Medicaid for at least 100 days of pregnancy and 90 days postpartum. We used logistic regression to calculate the association between pregnancy complications and having ≥1 ER visit in the 6 months postpartum. Results: We identified 26,074 pregnancies, of which 20% were complicated by GDM, gestational hypertension, or preeclampsia. Of these complicated pregnancies, 42.1% had GDM, 35.4% had gestational hypertension, and 42.5% had preeclampsia (diagnoses were not mutually exclusive). In the 6 months postpartum, 25% of women had ≥1 ER visits. Of the complicated pregnancy group, 27.7% had ≥1 ER visit, versus 23.6% of the comparison group (p

Original languageEnglish (US)
Pages (from-to)745-754
Number of pages10
JournalJournal of Women's Health
Volume24
Issue number9
DOIs
StatePublished - Sep 1 2015

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Insurance Claim Review
Medicaid
Postpartum Period
Hospital Emergency Service
Pregnancy
Pregnancy Induced Hypertension
Pregnancy Complications
Pre-Eclampsia
Gestational Diabetes
Managed Care Programs
Censuses
Ambulatory Care
Obstetrics
Primary Health Care
Cohort Studies
Outpatients
Logistic Models
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Emergency Room Utilization after Medically Complicated Pregnancies : A Medicaid Claims Analysis. / Harris, Ashley; Chang, Hsien-Yen; Wang, Lin; Sylvia, Martha; Neale, Donna M; Levine, David; Bennett, Wendy.

In: Journal of Women's Health, Vol. 24, No. 9, 01.09.2015, p. 745-754.

Research output: Contribution to journalArticle

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