The effect of severe maternal morbidity on infant costs and lengths of stay

Phibbs, Claire M.; Kozhimannil, Katy B.; Leonard, Stephanie A.; Lorch, Scott A.; Main, Elliott K.; Schmitt, Susan; Phibbs, Ciaran S.

doi:10.1038/s41372-022-01343-3

Cited by 7 publications

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the United States, severe maternal morbidity occurs in 1.1 -1.4% of inpatient deliveries [1,2]. Severe maternal morbidity increases maternal and infant care costs and is associated with an increased risk for neonatal mortality [3][4][5]. Women from racialized groups experience higher rates of severe maternal morbidity [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Validation of a measure of hospital maternal level of care for the United States

Vanderlaan,

Shen,

McDonough

2024

BMC Health Serv Res

View full text Add to dashboard Cite

Background Lack of a validated assessment of maternal risk-appropriate care for use in population data has prevented the existing literature from quantifying the benefit of maternal risk-appropriate care. The objective of this study was to develop a measure of hospital maternal levels of care based on the resources available at the hospital, using existing data available to researchers. Methods This was a secondary data analysis. The sample was abstracted from the American Hospital Association Annual Survey Database for 2018. Eligibility was limited to short-term acute general hospitals that reported providing maternity services as measured by hospital reporting of an obstetric service level, obstetric services, or birthing rooms. We aligned variables in the database with the ACOG criteria for each maternal level of care, then built models that used the variables to measure the maternal level of care. In each iteration, the distribution of hospitals was compared to the distribution in the CDC Levels of Care Assessment Tool Validation Pilot, assessing agreement with the Wilson Score for proportions for each level of care. Results were compared to hospital self-report in the database and measurement reported with another published method. Results The sample included 2,351 hospitals. AHA variables were available to measure resources that align with ACOG Levels 1, 2, and 3. Overall, 1219 (51.9%) of hospitals reported resources aligned with Maternal Level One, 816 (34.7%) aligned with maternal level two, and 202 (8.6%) aligned with maternal level Three. This method overestimates the prevalence of hospitals with maternal level one compared to the CDC measurement of 36.1% (Mean 52.9%; 95% CI47.2%—58.7%), and likely includes hospitals that would not qualify as level one if all resources required by the ACOG guidelines could be assessed. This method underestimates the prevalence of hospitals with maternal critical care services (Level 3 or 4) compared to CDC measure of 12.1% (Mean 8.1%; 95%CI 6.2% – 10.0%) but is an improvement over hospital self-report (24.7%) and a prior published method (32.3%). Conclusions This method of measuring maternal level of care allows researchers to investigate the value of perinatal regionalization, risk-appropriate care, and hospital differences among the three levels of care. This study identified potential changes to the American Hospital Association Annual Survey that would improve identification of maternal levels of care for research.

show abstract

Section: Introductionmentioning

confidence: 99%

Validation of a measure of hospital maternal level of care for the United States

Vanderlaan,

Shen,

McDonough

2024

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

Using Prevention Research to Reduce Racial Disparities in Health Through Innovative Funding Strategies: The Case of Doula Care

Temple

Varshney

2023

Prev Sci

View full text Add to dashboard Cite

Racial disparities in maternal birth outcomes are substantial even when comparing women with similar levels of education. While racial differences in maternal death at birth or shortly afterward have attracted significant attention from researchers, non-fatal but potentially life-threatening pregnancy complications are 30–40 times more common than maternal deaths. Black women have the worst maternal health outcomes. Only recently have health researchers started to view structural racism rather than race as the critical factor underlying these persistent inequities. We discuss the economic framework that prevention scientists can use to convince policymakers to make sustainable investments in maternal health by expanding funding for doula care. While a few states allow Medicaid to fund doula services, most women at risk of poor maternal health outcomes arising from structural racism lack access to culturally sensitive caregivers during the pre-and post-partum periods as well as during birth. We provide a guide to how research in health services can be more readily translated to policy recommendations by describing two innovative ways that cost–benefit analysis can help direct private and public funding to support doula care for Black women and others at risk of poor birth outcomes.

show abstract

Pre-pregnancy Weight and Racial-Ethnic Disparities in Pregnancy-Associated Conditions in the State of Georgia: A Population-Based Study

Ramisetty-Mikler,

Willis,

Tiwari

2024

J. Racial and Ethnic Health Disparities

View full text Add to dashboard Cite

The effect of severe maternal morbidity on infant costs and lengths of stay

Cited by 7 publications

References 22 publications

Validation of a measure of hospital maternal level of care for the United States

Validation of a measure of hospital maternal level of care for the United States

Using Prevention Research to Reduce Racial Disparities in Health Through Innovative Funding Strategies: The Case of Doula Care

Pre-pregnancy Weight and Racial-Ethnic Disparities in Pregnancy-Associated Conditions in the State of Georgia: A Population-Based Study

Contact Info

Product

Resources

About