Understanding categories of postpartum care use among privately insured patients in the United States: a cluster-analytic approach

Abstract

The postpartum period is critical for the health and well-being of birthing people, yet little is known about the range of health care services and supports needed during this time. Maternity care patients are often targeted for clinical interventions based on “low-risk” or “high-risk” designations, but dichotomized measures can be imprecise and may not reflect meaningful groups for understanding needed postpartum care. Using claims data from privately insured patients with childbirths between 2016 and 2018, this study identifies categories and predictors of postpartum care utilization, including use of maternal care and other, non-maternal care (e.g., respiratory, digestive). We then compare identified utilization-based categories to typical high- and low-risk designations. Among 269,992 patients, five categories were identified: 1) low use (55% of births); 2) moderate maternal care use, low other care use (25%); 3) moderate maternal, high other (8%); 4) high maternal, moderate other (7%); and 5) high maternal, high other (5%). Utilization-based categories were better at differentiating postpartum care use and were more consistent across patient profiles, compared to high- and low-risk dichotomies. Identifying categories of postpartum care need beyond a simple risk dichotomy is warranted and can assist in maternal health services research, policy-making, and clinical practice.