Administrative Supplement to Policy Change and Women's Health

政策变化和妇女健康的行政补充

基本信息

批准号：
10194963
负责人：
Claire E Margerison
金额：
$ 22.5万
依托单位：
MICHIGAN STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-16 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10194963
关键词：
Address Administrative Supplement Affordable Care Act African American Alaska Native Alcohol or Other Drugs use Caring Cessation of life Clinical Conceptions Contraceptive methods Data Death Records Domestic Violence Eligibility Determination Ethnic Origin Face Fertility Goals Health Health Insurance Health Policy Health Services Accessibility Health behavior Homicide Hypertension Improve Access Income Indigenous Insurance Insurance Coverage Intervention Knowledge Low income Measures Medicaid Medicaid eligibility Mental Health Methodology Methods Monitor Native Americans Not Hispanic or Latino Outcome Overdose Parents Perinatal Pharmaceutical Preparations Policies Postpartum Period Pregnancy Pregnancy Rate Privatization Public Health Race Reproductive Health Research Resources Risk Risk Factors Suicide System Testing Vital Statistics Woman Women&apos s Health depressive symptoms health care service utilization improved interest mortality perinatal period postpartum care postpartum health pregnancy associated death racial and ethnic racial and ethnic disparities screening unintended pregnancy violence victimization

项目摘要

PROJECT SUMMARY The central goal of our parent R01 project, Policy Change and Women's Health (HDR01095951), is to examine the impact of Medicaid expansion, particularly under the Affordable Care Act (ACA), on preconception health, reproductive health behavior (e.g., contraception, unintended pregnancy, and fertility), and pregnancy health and outcomes. With this Supplement request, we propose to extend our inquiry to address the impact of Medicaid expansion on pregnancy-associated mortality and its determinants in the postpartum period. Prior to the ACA Medicaid expansions, many low-income women who qualified for Medicaid during pregnancy lacked health insurance coverage prior to conception and subsequently lost coverage 60 days after delivery. This discontinuity of insurance across the perinatal period may be a key determinant in pregnancy-associated mortality. The expansion of Medicaid to low income women regardless of pregnancy status offers an opportunity to examine whether increasing continuity of insurance prior to and after pregnancy improves postpartum health care utilization, mental health, and rates of pregnancy-associated mortality. Thus, we will extend Aim 1 of our Parent R01, which assesses the impact of Medicaid expansion on preconception health care utilization, health behavior, and health using Pregnancy Risk Monitoring System (PRAMS) 2012-2017 data to also assess postpartum continuity of insurance, health care utilization, and mental health. We will extend Aim 3 of our Parent R01, which examines the impact of Medicaid expansion on pregnancy health and outcomes using vital statistics data, to assess overall and cause-specific pregnancy-related mortality. Moreover, we will examine racial/ethnic inequities in the impact of Medicaid expansion on both determinants of and rates in pregnancy-associated mortality. Achieving these aims will expand research on one of the potential leading causes of pregnancy-associated mortality in the U.S.: discontinuous insurance during the perinatal period, particularly the cessation of Medicaid eligibility after 60 days postpartum. We will also identify how policy-level determinants impact racial/ethnic disparities in risk factors for and rates of pregnancy-associated mortality in the U.S.

项目摘要我们的父母R01项目，政策变更和妇女健康（HDR01095951）的核心目标是检查医疗补助扩张的影响，特别是根据《平价医疗法案》（ACA）对预选健康的影响，生殖健康行为（例如避孕，意外怀孕和生育能力）和妊娠健康和结果。通过此补充要求，我们建议扩展我们的询问，以解决在产后时期，医疗补助与妊娠相关死亡率及其决定因素的扩展。之前 ACA医疗补助扩张，许多在怀孕期间获得医疗补助资格的低收入妇女缺乏构想之前的健康保险范围，随后在交货后60天失去了覆盖范围。这整个围产期保险的不连续性可能是与怀孕相关的关键决定因素死亡。不管怀孕状况如何有机会检查怀孕前后的保险连续性是否有所改善产后医疗保健利用，心理健康和与妊娠相关的死亡率的率。因此，我们会的扩展我们父母R01的AIM 1，该AIM 1评估了医疗补助扩张对孕前健康的影响使用怀孕风险监测系统（PRAMS）2012-2017的护理利用，健康行为和健康还可以评估保险，医疗保健利用和心理健康的产后连续性。我们将我们的父母R01的AIM 3，该AIM 3研究了医疗补助扩张对妊娠健康的影响使用重要统计数据的结果，以评估总体和特定妊娠有关的死亡率。此外，我们将研究医疗补助扩张对两种决定因素的影响的种族/种族不平等和妊娠相关死亡率的率。实现这些目标将扩大对潜力之一的研究美国的主要原因是美国的妊娠相关死亡率：围产期期间不连续的保险期间，特别是产后60天后的医疗补助资格停止。我们还将确定如何政策级别的决定因素会影响种族/种族差异的风险因素和与怀孕相关的率美国死亡率