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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
An Examination of the Effect of Postpartum Medicaid on Maternal Morbidity

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자료유형  
 학위논문 서양
최종처리일시  
20260202104842
ISBN  
9798293825097
DDC  
610.73
저자명  
Cline, Alice Curtis.
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  
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■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.

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