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失去与妊娠相关的医疗补助保险与产后女性未满足的医疗需求、医疗经济困难以及较低的医疗保健利用率有关。

Loss of Pregnancy-Related Medicaid Coverage Is Associated With Unmet Need for Health Care, Medical Financial Hardship, and Lower Health Care Use in Postpartum Women.

作者信息

Sanjeevi Namrata, Hebert Luciana E, Mandal Bidisha, Monsivais Pablo

机构信息

Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine Washington State University Spokane Washington USA.

Institute for Research and Education to Advance Community Health Washington State University Seattle Washington USA.

出版信息

Public Health Chall. 2025 Mar 11;4(1):e70044. doi: 10.1002/puh2.70044. eCollection 2025 Mar.

Abstract

OBJECTIVES

We examined the association of loss of pregnancy-related Medicaid coverage with unmet health care needs, medical financial hardship, and health care use in postpartum women participating in a nationally representative household survey.

DESIGN

Cross-sectional study design.

SAMPLE AND MEASUREMENTS

Using 2012-2018 National Health Interview Survey data, we classified postpartum women as either (1) having Medicaid coverage or (2) uninsured due to loss of pregnancy-related Medicaid coverage. We examined the relationship of loss of pregnancy-related Medicaid coverage with unmet health care needs, medical financial hardship, and health care use.

RESULTS

Compared to Medicaid-insured postpartum women, uninsured women who lost pregnancy-related Medicaid coverage had significantly greater odds of delaying medical care due to cost, as well as greater odds of unmet need for medical care, mental health care, and prescriptions. Uninsured postpartum women who lost pregnancy-related Medicaid coverage also had significantly greater odds of medical financial hardship and lower odds of health care use.

CONCLUSIONS

Findings suggest that continued Medicaid coverage during postpartum could improve health care access among uninsured women experiencing loss of pregnancy-related Medicaid eligibility. These results hold important implications for the public health impact of recent policy efforts to extend Medicaid eligibility into the postpartum period.

摘要

目的

我们在一项具有全国代表性的家庭调查中,研究了产后妇女失去与妊娠相关的医疗补助覆盖与未满足的医疗需求、医疗经济困难及医疗服务利用之间的关联。

设计

横断面研究设计。

样本与测量

利用2012 - 2018年全国健康访谈调查数据,我们将产后妇女分为两类:(1)拥有医疗补助覆盖;(2)因失去与妊娠相关的医疗补助覆盖而未参保。我们研究了失去与妊娠相关的医疗补助覆盖与未满足的医疗需求、医疗经济困难及医疗服务利用之间的关系。

结果

与有医疗补助的产后妇女相比,因失去与妊娠相关的医疗补助覆盖而未参保的妇女,因费用问题推迟就医的几率显著更高,未满足医疗、心理健康护理及处方需求的几率也更高。因失去与妊娠相关的医疗补助覆盖而未参保的产后妇女出现医疗经济困难的几率也显著更高,而医疗服务利用几率更低。

结论

研究结果表明,产后持续的医疗补助覆盖可改善那些失去与妊娠相关医疗补助资格的未参保妇女获得医疗服务的情况。这些结果对于近期将医疗补助资格扩展至产后阶段的政策努力所产生的公共卫生影响具有重要意义。

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Factors Associated With Postpartum Uninsurance Among Medicaid-Paid Births.与医疗补助计划支付的分娩后失去保险相关的因素。
JAMA Health Forum. 2021 Jun 14;2(6):e211054. doi: 10.1001/jamahealthforum.2021.1054. eCollection 2021 Jun.

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