Journal article
Postpartum health care expenditures for commercially insured deliveries with and without severe maternal morbidity
American journal of obstetrics & gynecology MFM, Vol.6(1), 101225
01/2024
DOI: 10.1016/j.ajogmf.2023.101225
PMID: 37972925
Abstract
Background
Although severe maternal morbidity is associated with adverse health outcomes in the year after delivery, patterns of health care use beyond the 6-week postpartum period have not been well documented.
Objective
To estimate health care utilization and expenditures for deliveries with and without severe maternal morbidity in the 12 months following delivery among commercially insured patients.
Study Design
Using data from the 2016-2018 IBM Marketscan Commercial Claims and Encounters Research Databases, we identified deliveries to individuals 15-49 years of age who were continuously enrolled in non-capitated health plans for 12 months after delivery discharge. We used multivariable generalized linear models to estimate adjusted mean 12-month medical expenditures and 95% confidence intervals for deliveries with and without severe maternal morbidity, accounting for region, health plan type, delivery method, and obstetric comorbidities. We estimated expenditures associated with inpatient admissions, non-emergency outpatient visits, outpatient emergency department visits, and outpatient pharmaceutical claims.
Results
We identified 366,282 deliveries without severe maternal morbidity and 3,976 deliveries (10.7 per 1,000) with severe maternal morbidity. Adjusted mean total medical expenditures for deliveries with severe maternal morbidity were 43% higher in the 12 months after discharge than deliveries without severe maternal morbidity ($5,320 vs $3,041; difference $2,278, 95% confidence interval: $1,591-2,965). Adjusted mean expenditures for readmissions and non-emergency outpatient visits during the 12-month postpartum period were 61% and 39% higher, respectively, for deliveries with severe maternal morbidity compared with deliveries without severe maternal morbidity. Among deliveries with severe maternal morbidity, adjusted mean total costs were highest for patients living in the western region ($7,831, 95% confidence interval $5,518-10,144) and those having a primary cesarean ($7,647, 95% confidence interval $6,323-8,970).
Conclusions
Severe maternal morbidity at delivery is associated with increased health care use and expenditures in the year after delivery. These estimates can inform planning of severe maternal morbidity prevention efforts.
Details
- Title: Subtitle
- Postpartum health care expenditures for commercially insured deliveries with and without severe maternal morbidity
- Creators
- Sheree L BouletKaitlyn K StanhopeMarissa PlatnerLauren K CostleyDenise J Jamieson
- Resource Type
- Journal article
- Publication Details
- American journal of obstetrics & gynecology MFM, Vol.6(1), 101225
- DOI
- 10.1016/j.ajogmf.2023.101225
- PMID
- 37972925
- ISSN
- 2589-9333
- eISSN
- 2589-9333
- Language
- English
- Electronic publication date
- 11/2023
- Date published
- 01/2024
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984508859602771
Metrics
2 Record Views