Maternal HealthPostpartum Care Visit Attendance Within 60 Days of Delivery Among Women With and Without Opioid Use During Pregnancy: An Analysis of Commercial Insurance Data
Section snippets
Data Source and Study Sample
Data for this retrospective cohort study were obtained from the MarketScan Commercial Claims and Encounters Database, which contains paid health and pharmaceutical insurance claims for people with employer-sponsored, private health insurance in the United States. MarketScan includes paid claims for inpatient admissions, outpatient encounters, and outpatient pharmaceutical prescriptions and insurance enrollment information for an estimated 100 million enrollees (IBM Watson Health, 2018). Women
Results
Table 1 shows the distribution of demographic, opioid use, and clinical characteristics in the study cohort overall and by PPC status. Approximately 45% of women in the sample had a PPC visit within 60 days of delivery. A higher percentage of women in any opioid use category attended a PPC visit (50.1% among nonchronic users, 50.6% among women with OUD, and 55.6% among chronic users) than women who did not use opioids (44.5%). A higher percentage of women who attended any ANC also attended a
Discussion
Our study used nationwide claims data to assess differences in PPC visit attendance among women who did not use opioids during pregnancy and different types of opioid users in a privately insured population. Fewer than half (45%) of women in our study had a PPC visit, despite the high prevalence of some clinical risk factors in this cohort. Women with no opioid use had particularly low PPC attendance whereas just over half of women with any form of opioid use attended PPC, with the highest
Acknowledgments
The authors thank the Johns Hopkins Center for Drug Safety and Effectiveness for providing access to the MarketScan database.
Blair O. Berger, PhD, MSPH, is a postdoctoral research fellow at the Johns Hopkins Bloomberg School of Public Health. Her research focuses on measurement methods and applied epidemiology approaches to improve maternal morbidity, birth outcomes, and quality of care in maternity.
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Cited by (0)
Blair O. Berger, PhD, MSPH, is a postdoctoral research fellow at the Johns Hopkins Bloomberg School of Public Health. Her research focuses on measurement methods and applied epidemiology approaches to improve maternal morbidity, birth outcomes, and quality of care in maternity.
Leah G. Horton, PhD, MSPH, researches maternal and reproductive health outcomes among traditionally marginalized populations in the US, with particular focus on postpartum contraceptive use dynamics among women who use opioids.
Alison Gemmill, PhD, MPH, is an assistant professor at Johns Hopkins Bloomberg School of Public Health. Her research aims to improve the health of women and children using a population-health and life-course perspective.
Donna M. Strobino, PhD, is a professor emeritus at the Johns Hopkins Bloomberg School of Public Health. Her research focuses on understanding the reasons disadvantaged women have higher rates of unfavorable pregnancy outcomes, interventions to improve their outcomes, and maternal morbidity and mental health.
Funding Statement: This work was supported by the Maternal and Child Health Training Grant through the Johns Hopkins Center of Excellence in Maternal and Child Health Education, Science, and Practice through Maternal and Child Health Bureau/Health Resources and Services Administration (fellows: B.O.B. and L.G.H.). The authors have no financial conflicts to disclose.