Department of Economics, University at Albany and NBER, Albany, New York, USA.
Department of Economics, Emory University, Atlanta, Georgia, USA.
Health Econ. 2023 Oct;32(10):2334-2352. doi: 10.1002/hec.4724. Epub 2023 Jul 7.
In this paper, we test whether the Affordable Care Act Medicaid expansions are associated with maternal morbidity. The ACA expansions may have affected maternal morbidity by increasing pre-conception access to health care, and by improving the quality of delivery care, through enhancing hospitals' financial positions. We use difference-in-difference models in conjunction with event studies. Data come from individual-level birth certificates and state-level hospital discharge data. The results show little evidence that the expansions are associated with overall maternal morbidity or indicators of specific adverse events including eclampsia, ruptured uterus, and unplanned hysterectomy. The results are consistent with prior research showing that the ACA Medicaid expansions are not statistically associated with pre-pregnancy health or maternal health during pregnancy. Our results add to this story and find little evidence of improvements in maternal health upon delivery.
在本文中，我们检验了《平价医疗法案》（ACA）的医疗补助扩张计划是否与产妇发病率有关。ACA 扩张可能通过增加受孕前获得医疗保健的机会，并通过提高医院的财务状况来改善分娩护理质量，从而影响产妇发病率。我们使用双重差分模型结合事件研究。数据来自个人层面的出生证明和州层面的医院出院数据。结果表明，扩张计划与总体产妇发病率或特定不良事件的指标（包括子痫、子宫破裂和非计划子宫切除术）之间几乎没有关联。这些结果与先前的研究一致，即 ACA 医疗补助扩张计划与孕前健康或怀孕期间的产妇健康没有统计学上的关联。我们的结果补充了这一故事，几乎没有发现分娩时产妇健康状况有所改善的证据。
