Medicaid Expansion in Oregon: Access and Health Outcomes for Women and Infants

俄勒冈州医疗补助扩张：妇女和婴儿的获取和健康成果

• 批准号: 8629470
• 负责人: Sandy Marie Harvey
• 金额: $ 24.92万
• 依托单位: OREGON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2018-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8629470
• 关键词: Medicaid; Expansion; Oregon; Access; Health

Abstract Early intervention to identify and treat chronic disease and modify behavioral risk factors among women of reproductive age has the potential to significantly reduce their morbidity and mortality and improve their pregnancy outcomes. Lack of health insurance has been a major barrier to early intervention and preventive care among low-income women of reproductive age. However, the 2014 expansion of Medicaid under the Patient Protection and Affordable Care Act (ACA) will make millions of low-income women newly eligible for Medicaid and preventive health services. An integrated data system is essential to evaluate the impact of this expansion on the health of women of reproductive age and their infants. Research using this data system will inform future program planning and identify best practices and areas of greatest need. We propose to create an integrated data system that links Oregon Medicaid data with birth and death certificates and hospital discharge data. Further, we will include data on the quality of Medicaid services that are not available to other states. The proposed study is a collaborative effort between Oregon State University and the Oregon Health Authority. Oregon is an ideal state in which to conduct the proposed study because of its ongoing commitment to Medicaid health care delivery reform and the commitment of state leaders to collaborate across divisions and programs to ensure this project's success. The project also has the support of key state stakeholders in maternal and child health and women's health. The specific aims of the proposal are to1) develop a research agenda, in collaboration with key stakeholders, to evaluate the expansion of Medicaid on the health of Medicaid-eligible women of reproductive age, mothers, and infants in Oregon; 2) link Oregon Medicaid data for female enrollees ages 15-44 and their infants to statewide datasets, including (but not limited to) live birth, fetal death, infant death, and hospital discharge data, beginning with 2008 and continuing until 2016, as data become available; and 3) conduct planned analyses and disseminate findings. The research agenda will include key research questions that assess the effect of Medicaid expansion on Medicaid enrollment and access to care for low-income women; utilization of services by women and infants enrolled in Medicaid; general health behaviors, risks, and outcomes for these women; and pregnancy complications and poor birth outcomes. We will also measure disparities that remain after Medicaid expansion, to inform strategies to mitigate those disparities on an ongoing basis. We will use results of these analyses to construct simulations that extend this study's findings into implications and lessons for policy makers and stakeholders in other states that are expanding Medicaid. Results of these analyses and simulations will provide valuable information to support health reform efforts, both in Oregon and across the U.S, to reduce the public health burden and improve population health among women of reproductive age, including pregnancy and infant health outcomes.

抽象的 早期干预以识别和治疗慢性疾病并修改妇女的行为风险因素 生殖年龄有可能显着降低其发病率和死亡率并改善其 怀孕结果。缺乏健康保险是早期干预和预防性的主要障碍 繁殖年龄的低收入妇女的护理。但是，2014年的医疗补助规定 患者保护和负担得起的护理法案（ACA）将使数百万低收入妇女刚有资格 医疗补助和预防保健服务。集成数据系统对于评估这一影响至关重要 扩大生殖年龄及其婴儿的健康。使用此数据系统的研究将 为未来的计划计划提供信息，并确定最佳实践和最需要的领域。我们建议创建 将俄勒冈州医疗补助数据与出生和死亡证明和医院联系起来的综合数据系统 排放数据。此外，我们将包括有关其他医疗补助服务质量的数据 国家。拟议的研究是俄勒冈州立大学与俄勒冈州健康之间的合作努力 权威。俄勒冈州是进行拟议研究的理想状态，因为其持续的承诺 进行医疗补助医疗保健提供改革和国家领导人跨部门合作的承诺 和计划以确保该项目的成功。该项目还得到了关键国家利益相关者的支持 孕产妇健康与妇女健康。该提案的具体目的是TO）进行研究 议程与主要利益相关者合作，以评估医疗补助的扩大 俄勒冈州符合医疗补助符合生殖年龄，母亲和婴儿的妇女； 2）链接俄勒冈州医疗补助数据 15-44岁的雌性入学人士及其婴儿到全州数据集，包括（但不限于）活产，胎儿 死亡，婴儿死亡和医院出院数据，从2008年开始，一直持续到2016年，作为数据 可用； 3）进行计划的分析并传播发现。研究议程将 包括评估医疗补助扩展对医疗补助入学率的影响的关键研究问题和 获得低收入妇女的护理；使用医疗补助的妇女和婴儿使用服务； 这些妇女的一般健康行为，风险和结果；和怀孕并发症和出生不良 结果。我们还将衡量医疗补助扩张后仍然存在的差异，以告知策略 持续减轻这些差异。我们将使用这些分析的结果来构建模拟 这将这项研究的发现扩展到了对其他政策制定者和利益相关者的影响和教训 正在扩大医疗补助的州。这些分析和模拟的结果将提供有价值的 支持俄勒冈州和整个美国的健康改革努力的信息，以减少公共卫生 生殖年龄妇女的负担和改善人口健康，包括怀孕和婴儿 健康结果。