Slawa Rokicki (
Health Aff (Millwood). 2024 Apr;43(4):477-485. doi: 10.1377/hlthaff.2023.01443.
In New Jersey, universal screening for perinatal depression at the time of delivery has resulted in a 95 percent screening rate. The widespread availability of screening data allowed me to investigate the association between perinatal depression severity and infant emergency department (ED) use and charges in the first year of life. I used birth records linked to hospital discharge records for the period 2016-19. Compared with infants who had mothers with no symptoms, infants with mothers with mild or moderate/severe depressive symptoms had significantly higher overall and nonemergent ED use, but not significantly higher emergent ED use. The positive associations between depressive symptoms and ED charges were particularly striking for infants with Medicaid, which pays for a disproportionate share of pediatric ED care in the United States. This study contributes to the evidence base linking perinatal depression screening and pediatric ED use. Opportunities may exist within Medicaid to optimize screening and referrals for perinatal depression, with potential cost-saving benefits for reducing nonemergent pediatric ED visits.
在新泽西州,分娩时进行围产期抑郁的普遍筛查导致了 95%的筛查率。广泛提供的筛查数据使我能够调查围产期抑郁严重程度与婴儿在生命的第一年急诊部(ED)使用和费用之间的关联。我使用了 2016-19 年期间与医院出院记录相关联的出生记录。与母亲无症状的婴儿相比,母亲有轻度或中重度/重度抑郁症状的婴儿的整体和非紧急 ED 使用明显更高,但紧急 ED 使用没有明显更高。对于使用医疗补助的婴儿,抑郁症状与 ED 费用之间的正相关关系尤为显著,因为医疗补助在美国支付了不成比例的儿科 ED 护理费用。这项研究为围产期抑郁筛查与儿科 ED 使用之间的联系提供了证据基础。在医疗补助范围内可能存在优化围产期抑郁筛查和转介的机会,这可能会节省减少非紧急儿科 ED 就诊的成本。