Hersh Alyssa, Martinez Acevedo Ann, Mandelbaum Ava, Choo Esther, Rodriguez Maria
Oregon Health & Science University.
Res Sq. 2024 Dec 12:rs.3.rs-5433292. doi: 10.21203/rs.3.rs-5433292/v1.
Emergency department (ED) use is common among patients with Medicaid insurance during pregnancy. However, it is unknown how ED utilization differs among those with different types of Medicaid such as Emergency Medicaid, with which access to outpatient care is more restricted.
We sought to compare differences in ED use during between pregnant persons with Emergency Medicaid and Traditional Medicaid and pregnancy outcomes by ED utilization.
This was a retrospective cohort study of all births among Medicaid recipients in South Carolina from 2010 to 2019. The main comparator was type of Medicaid. Our primary outcome was an ED visit during pregnancy. Secondary outcomes included average number of visits, perinatal outcomes, and prenatal and hospital charges.
There were 240,597 births that met inclusion criteria for this analysis. Over the study period, the proportion of patients with at least one ED visit increased for all groups. A higher proportion of patients with Traditional Medicaid had at least one ED visit compared with Emergency Medicaid (58.2% versus 22.7%). Patients who had at least one ED visit were more likely to be younger, of Black race, live rurally, nulliparous, have lower or higher body mass index, and have a higher prevalence of pre-existing medical co-morbidities.
We found that individuals with Traditional Medicaid were more likely to have an antenatal ED visit than individuals with Emergency Medicaid.
孕期医疗补助保险患者频繁使用急诊科。然而，不同类型的医疗补助（如急诊医疗补助，其门诊就医机会更有限）患者的急诊科利用率差异尚不清楚。
我们试图比较急诊医疗补助孕妇和传统医疗补助孕妇在急诊科就诊情况的差异，以及根据急诊科利用率得出的妊娠结局差异。
这是一项对2010年至2019年南卡罗来纳州医疗补助受助人所有分娩情况的回顾性队列研究。主要比较对象是医疗补助类型。我们的主要结局是孕期的急诊科就诊情况。次要结局包括就诊平均次数、围产期结局以及产前和住院费用。
有240,597例分娩符合本分析的纳入标准。在研究期间，所有组中至少有一次急诊科就诊的患者比例均有所增加。与急诊医疗补助患者相比，传统医疗补助患者中至少有一次急诊科就诊的比例更高（58.2%对22.7%）。至少有一次急诊科就诊的患者更可能年轻、为黑人、居住在农村、初产、体重指数较低或较高，且既往有合并症的患病率更高。
我们发现，与急诊医疗补助患者相比，传统医疗补助患者更有可能进行产前急诊科就诊。
