ArticleThe American journal of managed care2013
Trends in hospital-based childbirth care: the role of health insurance.
Article in The American journal of managed care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Caesarean section in uninsured women in the USA: systematic review and meta-analysis.BMJ open · 2019Pooled it
- Pooled it
- Focus on postpartum care transitions: a pathway to improve perinatal health.Health affairs scholar · 2026Article
- The association of NICU capacity strain with neonatal mortality and morbidity.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Understanding delivery type as a mediator in the relationship between insurance type and permanent contraception fulfillment: a mixed-methods multi-site study.Reproductive health · 2025Article
- The impact of volume and neonatal level of care on outcomes of moderate and late preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Length of stay and determinants of early discharge and extended stay after cesarean delivery in a resource-limited setting: southern Ethiopia, 2023.Frontiers in global women's health · 2024Article
- County-Level Maternal Vulnerability and Preterm Birth in the US.JAMA network open · 2023Article
- Racial Disparities in Respectful Maternity Care During Pregnancy and Birth After Cesarean in Rural United States.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2023Observational
- Changes in prenatal testing during the COVID-19 pandemic.Frontiers in pediatrics · 2022Article
- Demographic, Socioeconomic, Health Systems, and Geographic Factors Associated with Vaginal Birth After Cesarean: An Analysis of 2017 U.S. Birth Certificate Data.Maternal and child health journal · 2021Article
- Women's experience of agency and respect in maternity care by type of insurance in California.PloS one · 2020Article
- Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: A Consortium on Safe Labor study.Birth (Berkeley, Calif.) · 2019Observational
- Influence of midwifery presence in United States centers on labor care and outcomes of low-risk parous women: A Consortium on Safe Labor study.Birth (Berkeley, Calif.) · 2019Observational
- Article
- Maternal clinical diagnoses and hospital variation in the risk of cesarean delivery: analyses of a National US Hospital Discharge Database.PLoS medicine · 2014Article
- A Cross-Sectional Analysis of Expanding Maternity Care Deserts in Rural Kansas Counties, 2016-2023.Kansas journal of medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectivesChildbirth is the leading reason for hospitalization in the United States, and maternity related expenditures are substantial for many health insurance programs, including Medicaid. We studied the relationship between primary payer and trends in hospital-based childbirth care. STUDY DESIGNS: Retrospective analysis of hospital discharge data from the Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project, a 20% stratified sample of US hospitals.
methodsData on 6,717,486 hospital-based births for the years 2002 through 2009 came from the NIS. We used generalized estimating equations to measure associations over time between primary payer (Medicaid, private insurance, or self) and cesarean delivery, vaginal birth after cesarean (VBAC), labor induction, and episiotomy.
resultsControlling for clinical, demographic, and hospital factors, births covered by Medicaid had lower odds of cesarean delivery (adjusted odds ratio [AOR], 0.91), labor induction (AOR, 0.73), and episiotomy (AOR, 0.62) and higher odds of VBAC (AOR, 1.20; P <.001 for all AORs) compared with privately insured births. Cesarean rates increased 6% annually among births paid by private insurance (AOR, 1.06; P <.001) and less rapidly (5% annually) among those covered by Medicaid.
conclusionsUS hospital-based births covered by private insurance were associated with higher rates of obstetric intervention than births paid for by Medicaid. After controlling for clinical, demographic, and hospital factors, cesarean delivery rates increased more rapidly among births covered by private insurance, compared with Medicaid. Changes in insurance coverage associated with healthcare reform may impact costs and quality of care for women giving birth in US hospitals.
Indexed as
Identifiers
23725450PMC3671492W50734038What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.