怀孕前护理的使用:医疗补助的妇女之间的自我报告与基于索赔的措施
Debra B Stulberg1, L Philip Schumm2, Kellie Schueler3
1Department of Family Medicine, University of Chicago, Chicago, Illinois, United States of America.
通过比较自我报告和索赔数据,发现黑人和白人女性,以及患有或没有糖尿病/高血压的女性使用预孕护理的趋势相似. 对于其他种族/族群和抑郁症状况存在差异.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 生殖健康 生殖健康
背景情况:
- 孕前护理 (PCU) 对于改善母亲和婴儿的结果至关重要.
- 医疗补助申请数据和自我报告调查是研究PCU的常见来源,但它们的一致性尚未完全理解.
研究的目的:
- 为了比较医疗补助覆盖分娩中使用预孕护理 (PCU) 的情况,使用来自怀孕风险评估和监测系统 (PRAMS) 和医疗补助索赔数据 (医疗补助分析提取 - MAX) 的自我报告数据.
主要方法:
- 2012年利用来自26个州的医疗补助覆盖分娩数据 (年龄在15-45岁的妇女).
- 使用MAX中的诊断代码和PRAMS中的自我报告来识别PCU.
- 采用混合效应物流回归来分析PCU概率,基于社会人口统计因素和临床诊断 (抑郁症,糖尿病,高血压).
主要成果:
- 在MAX中,PCU率为28.1%,在PRAMS中为23.6%.
- 在两个数据集中,非西班牙裔黑人女性的PCU率高于非西班牙裔白人女性.
- 患有糖尿病或高血压的女性在两个数据集中都有更高的PCU率.
- 西班牙裔和亚裔妇女报告PCU较高,但与非西班牙裔白人妇女相比,基于索赔的利用率较低.
结论:
- 自我报告和索赔数据显示,基于种族/种族 (黑人与白人) 和慢性疾病 (糖尿病,高血压) 的PCU差异的趋势相似.
- 对其他种族/族群和抑郁状态的数据来源之间观察到差异.
- 医疗补助索赔数据对PCU研究有价值,但可能会错过某些护理类型或受到报告变化的影响,强调需要考虑数据源的优势和局限性.
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