Evidence map›Paper›PMID 30198185›Full record

Observational studyHealth services research2018

Selection of Higher Risk Pregnancies into Veterans Health Administration Programs: Discoveries from Linked Department of Veterans Affairs and California Birth Data.

Jonathan G Shaw, Vilija R Joyce, Susan K Schmitt, Susan M Frayne, Kate A Shaw, Beate Danielsen, Rachel Kimerling, Steven M Asch, Ciaran S Phibbs

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. The impact of military sexual trauma and warfare exposure on women veterans' perinatal outcomes.Psychological trauma : theory, research, practice and policy · 2022
    Article
  5. Article
  6. Article
  7. Observational
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Jonathan G ShawDivision of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA.ORCID 0000-0001-7884-3604
Vilija R JoyceVA HSR&D Health Economics Resource Center (HERC), US Department of Veterans Affairs, VA Palo Alto Health Care System, Palo Alto, CA.
Susan K SchmittVA HSR&D Health Economics Resource Center (HERC), US Department of Veterans Affairs, VA Palo Alto Health Care System, Palo Alto, CA.
Susan M FrayneDivision of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
Kate A ShawDepartment of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA.
Beate DanielsenHealth Information Solutions, Rocklin, CA.
Rachel KimerlingVA HSR&D Center for Innovation to Implementation (Ci2i), US Department of Veterans Affairs, VA Palo Alto Health Care System, Palo Alto, CA.
Steven M AschDivision of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
Ciaran S PhibbsVA HSR&D Center for Innovation to Implementation (Ci2i), US Department of Veterans Affairs, VA Palo Alto Health Care System, Palo Alto, CA.
United States Department of Veterans Affairs · USHealth Solutions (Sweden) · SEStanford University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo describe variation in payer and outcomes in Veterans' births. DATA/

settingSecondary data analyses of deliveries in California, 2000-2012. STUDY

designWe performed a retrospective, population-based study of all live births to Veterans (confirmed via U.S. Department of Veterans Affairs (VA) enrollment records), to identify payer and variations in outcomes among: (1) Veterans using VA coverage and (2) Veteran vs. all other births. We calculated odds ratios (aOR) adjusted for age, race, ethnicity, education, and obstetric demographics.

methodsWe anonymously linked VA administrative data for all female VA enrollees with California birth records. PRINCIPAL

findingsFrom 2000 to 2012, we identified 17,495 births to Veterans. VA covered 8.6 percent (1,508), Medicaid 17.3 percent, and Private insurance 47.6 percent. Veterans who relied on VA health coverage had more preeclampsia (aOR 1.4, CI 1.0-1.8) and more cesarean births (aOR 1.2, CI 1.0-1.3), and, despite similar prematurity, trended toward more neonatal intensive care (NICU) admissions (aOR 1.2, CI 1.0-1.4) compared to Veterans using other (non-Medicaid) coverage. Overall, Veterans' birth outcomes (all-payer) mirrored California's birth outcomes, with the exception of excess NICU care (aOR 1.15, CI 1.1-1.2).

conclusionsVA covers a higher risk fraction of Veterans' births, justifying maternal care coordination and attention to the maternal-fetal impacts of Veterans' comorbidities.

Indexed as

AdultCaliforniaCesarean SectionDelivery, ObstetricFemaleGestational AgeHumansInsurance CoverageInsurance, HealthIntensive Care Units, NeonatalMaternal Health ServicesMedicaidMiddle AgedPregnancyPregnancy ComplicationsPregnancy OutcomeCaliforniahealth servicesMaternal carepregnancyVeterans

Identifiers

PMID30198185
PMCPMC6235819
OpenAlexW2891412234

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.