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An Examination of the Effect of Postpartum Medicaid on Maternal Morbidity
An Examination of the Effect of Postpartum Medicaid on Maternal Morbidity
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202104842
- ISBN
- 9798293825097
- DDC
- 610.73
- 서명/저자
- An Examination of the Effect of Postpartum Medicaid on Maternal Morbidity
- 발행사항
- [Sl] : University of Pittsburgh, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 141 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-03, Section: A.
- 주기사항
- Advisor: Martsolf, Grant R.
- 학위논문주기
- Thesis (Ph.D.)--University of Pittsburgh, 2025.
- 초록/해제
- 요약The purpose of this study is to examine the current state of maternal health in the United States, and to assess the impact of health policy changes on maternal insurance coverage, healthcare utilization, and pregnancy outcomes. First, we used a nationally representative dataset from the Centers for Disease Control and Prevention to compare maternal-child health measures in states that did and did not expand Medicaid following the passage of the Affordable Care Act in 2010, using logistic regression analysis. Second, we used birth records from a regional health care system to describe the health complications affecting women in the year after birth, in frequencies and temporal pattern over the year. Third, we used the same medical record data to design a difference in difference study, that allowed us to measure the differential effect of health policy change on women whose births were paid for by Medicaid compared to women with private insurance at birth. This third study measured the effect of Pennsylvania's policy to extend Medicaid coverage for a full year after birth, comparing the rates of insurance continuity on the four time-payer groups: pre-extension Medicaid patients, pre-extension privately insured patients, post-extension Medicaid patients, and post-extension privately insured patients. Over the course of the three studies, we found that Medicaid expansion was associated with statistically significant improvements in insurance continuity, maternal healthcare utilization, and maternal-child health outcomes. We found that 55% of women (paper 2, n = 28,121) are affected by mild to moderate morbidity in the postpartum year. And we found that the extension of postpartum Medicaid may have protected Medicaid participants from the worsening insurance churn experienced by privately insured patients. It appears that postpartum Medicaid extension has likely substantial positive impact on postpartum women in the us. More research is needed using state- and nation-wide data sets, sources with more administrative insurance data between healthcare encounters, and reevaluating for changes after a greater interval of time since the policy implementation.
- 일반주제명
- Nursing
- 일반주제명
- Public health
- 일반주제명
- Obstetrics
- 일반주제명
- Public policy
- 키워드
- Maternal health
- 키워드
- Medicaid
- 키워드
- Midwifery
- 키워드
- Health policy
- 키워드
- United States
- 기타저자
- University of Pittsburgh Nursing
- 기본자료저록
- Dissertations Abstracts International. 87-03A.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■00520260202104842
■006m o d
■007cr#unu||||||||
■020 ▼a9798293825097
■035 ▼a(MiAaPQ)AAI32172997
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610.73
■1001 ▼aCline, Alice Curtis.▼0(orcid)0000-0001-9820-6020
■24513▼aAn Examination of the Effect of Postpartum Medicaid on Maternal Morbidity
■260 ▼a[Sl]▼bUniversity of Pittsburgh▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a141 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-03, Section: A.
■500 ▼aAdvisor: Martsolf, Grant R.
■5021 ▼aThesis (Ph.D.)--University of Pittsburgh, 2025.
■520 ▼aThe purpose of this study is to examine the current state of maternal health in the United States, and to assess the impact of health policy changes on maternal insurance coverage, healthcare utilization, and pregnancy outcomes. First, we used a nationally representative dataset from the Centers for Disease Control and Prevention to compare maternal-child health measures in states that did and did not expand Medicaid following the passage of the Affordable Care Act in 2010, using logistic regression analysis. Second, we used birth records from a regional health care system to describe the health complications affecting women in the year after birth, in frequencies and temporal pattern over the year. Third, we used the same medical record data to design a difference in difference study, that allowed us to measure the differential effect of health policy change on women whose births were paid for by Medicaid compared to women with private insurance at birth. This third study measured the effect of Pennsylvania's policy to extend Medicaid coverage for a full year after birth, comparing the rates of insurance continuity on the four time-payer groups: pre-extension Medicaid patients, pre-extension privately insured patients, post-extension Medicaid patients, and post-extension privately insured patients. Over the course of the three studies, we found that Medicaid expansion was associated with statistically significant improvements in insurance continuity, maternal healthcare utilization, and maternal-child health outcomes. We found that 55% of women (paper 2, n = 28,121) are affected by mild to moderate morbidity in the postpartum year. And we found that the extension of postpartum Medicaid may have protected Medicaid participants from the worsening insurance churn experienced by privately insured patients. It appears that postpartum Medicaid extension has likely substantial positive impact on postpartum women in the us. More research is needed using state- and nation-wide data sets, sources with more administrative insurance data between healthcare encounters, and reevaluating for changes after a greater interval of time since the policy implementation.
■590 ▼aSchool code: 0178.
■650 4▼aNursing
■650 4▼aPublic health
■650 4▼aObstetrics
■650 4▼aPublic policy
■653 ▼aMaternal health
■653 ▼aMedicaid
■653 ▼aMidwifery
■653 ▼aHealth policy
■653 ▼aUnited States
■690 ▼a0569
■690 ▼a0573
■690 ▼a0380
■690 ▼a0630
■71020▼aUniversity of Pittsburgh▼bNursing.
■7730 ▼tDissertations Abstracts International▼g87-03A.
■790 ▼a0178
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17359148▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.


