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- W3129149657 abstract "Patients with chronic disease are often more likely to have health insurance and continuous care; whether this trend applies to postpartum care remains unclear. We sought to determine whether patients with pre-existing comorbidities are less likely to experience insurance loss during postpartum readmission. Postpartum readmissions with loss of insurance (payer change to no insurance) occurring 2-9 months after delivery were identified using the 2010-2014 Nationwide Readmissions Database. Loss of insurance rates among readmissions were stratified by common comorbidities: pre-gestational diabetes (DM), asthma, Lupus, chronic kidney disease (CKD), and chronic hypertension (cHTN). Multivariable log linear regressions were fit to evaluate risk of insurance loss in patients with one or more comorbidities and also by specific comorbidity and adjusted for demographic factors. Adjusted risk ratios (aRR) were used as measures of association. We identified 55,285 postpartum readmissions, 12.3% (n=7,703) linked to delivery hospitalizations for patients with one or more chronic conditions. Insurance loss was 15.6% overall and 4.8% to 18.4% by comorbidity (Table 1). Multivariable analysis demonstrated one or more comorbidities was not associated with decreased risk of insurance loss (aRR 1.02, 95% CI 0.96, 1.08, p=0.61). DM was associated with higher risk of insurance loss (aRR 1.26, 95% CI 1.13, 1.41, p<0.01), Lupus and asthma were associated with lower risk of insurance loss (aRR 0.34, 95% CI 0.20, 0.60, p<0.01; aRR 0.88, 95% CI 0.81, 0.96, p<0.01) and cHTN and CKD were not significantly associated with insurance loss (Table 2). One or more chronic condition is not associated with decreased risk of insurance loss postpartum and insurance loss stratified by common comorbidity does not demonstrate a clear protective effect against insurance loss. Further research and policy measures are needed to evaluate the effects of insurance loss and ensure patients with chronic diseases access to care during the postpartum period.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
- W3129149657 created "2021-02-15" @default.
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- W3129149657 date "2021-02-01" @default.
- W3129149657 modified "2023-10-18" @default.
- W3129149657 title "1167 Association of chronic disease and loss of insurance postpartum" @default.
- W3129149657 doi "https://doi.org/10.1016/j.ajog.2020.12.1191" @default.
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