(SDAS) Perinatal Outcomes for Pregnant High Utilizers of Unscheduled Hospital-Based Care
Grantee: Trustees of Boston University, BUMC
Principal Investigator: Eugene Declercq
Project Number: R40MC29444
Project Date: 04/01/2016
Final Report
Age group(s)
- Women/Maternal
- Prenatal
- Perinatal/Infancy (0-12 months)
Targeted/Underserved Population
- African American
- Asian/Pacific Islander
- Hispanic/Latino
- Native American/Alaskan Native
Abstract
Principal needs and problems addressed: The proposed project will explore characteristics and outcomes associated with likely one of the highest risk populations in U.S. maternal and child health- regnant women who signal unmet need during pregnancy through the repetitive use of unscheduled care in emergency rooms and obstetric triage areas. While studies specific to pregnant high utilizers of unscheduled care are rare, work from other contexts has found high utilization to be clearly associated with underinsurance, poverty, intimate partner violence, childhood maltreatment, chronic illness, disability, housing instability, food insecurity, mental illness, and substance use disorder. This study will examine extremes of unscheduled care utilization by pregnant women at the state-level using a population health approach (Strategic Research Issue I). Our results will be stratified by race/ethnicity and insurance status to identify any sociocultural disparities in how perinatal health utilization behaviors may correlate to health system access and outcome (Strategic Research Issue II). We will also examine patterns in unscheduled high utilization by hospital level and type, individual use of outpatient prenatal and postpartum care, and associated maternal and infant health outcomes (Strategic Research Issue III). Our examination of long-term maternal health and the impact of maternal utilization behaviors and health system organization on infant health will address Strategic Research Issue IV on promoting healthy development. Database to be Analyzed: We will analyze births in Massachusetts from 1998-2012 using the Pregnancy to Early Life Longitudinal (PELL) dataset. PELL data from 1998-2011 includes 1,032,700 live births and 5,251 fetal deaths occurring to 720,317 mothers.<< Previous Next >>