Evidence map›Paper›PMID 32896469›Full record

ArticleWomen's health issues : official publication of the Jacobs Institute of Women's Health

Out-of-Pocket Medical Bills from First Childbirth and Subsequent Childbearing.

Yubraj Acharya, Marianne M Hillemeier, Kristin K Sznajder, Kristen H Kjerulff

Abstract read
In one paragraph

Article in Women's health issues : official publication of the Jacobs Institute of Women's Health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Yubraj AcharyaDepartment of Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania. Electronic address: yua36@psu.edu.
Marianne M HillemeierDepartment of Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania.
Kristin K SznajderDepartment of Public Health Sciences, The Pennsylvania State University, Hershey, Pennsylvania.
Kristen H KjerulffDepartments of Public Health Sciences and Obstetrics and Gynecology, The Pennsylvania State University, Hershey, Pennsylvania.

Funding

The Population Research Institute: Development CoreP2CHD041025 · NICHD · PENNSYLVANIA STATE UNIVERSITY, THE · PI Sarah Damaske · 2016 to 2026
$9.0M
Mode of First Delivery and Subsequent Child-BearingR01HD052990 · NICHD · PENNSYLVANIA STATE UNIV HERSHEY MED CTR · PI KJERULFF, KRISTEN HAWTHORNE · 2008 to 2012
$3.9M
NICHD NIH HHS P2C HD041025NICHD NIH HHS R01 HD052990
6 · The paper itself

Abstract

introductionMany families in the United States struggle to pay medical debt. This study aims to investigate the association between having out-of-pocket medical bills from first childbirth sent to debt collection agencies and subsequent childbearing.

methodsAs part of a large-scale birth cohort study (N = 2,169), women in Pennsylvania who delivered their first child in 2009 through 2011 were asked if any of the out-of-pocket medical expenditures resulting from the delivery were sent to debt collection agencies. Logistic regression models were used to assess the association between childbirth medical bills going to debt collections in the first year after delivery and subsequent childbearing over the following 2 years, controlling for relevant confounders, including maternal age, education, race/ethnicity, marital status, poverty level, insurance coverage, pregnancy intendedness, difficulty paying for basic needs, plans to have another child, pregnancy complications, and childbirth maternal and neonatal complications.

resultsWomen received out-of-pocket medical bills for as much as $32,000. Overall, 8.3% reported having medical bills from the childbirth sent to debt collections. These women were substantially less likely to have a subsequent child during the follow-up period (22.4%) compared with their counterparts, whose medical bills did not go to collections (44.4%; adjusted odds ratio, 0.60; 95% confidence interval, 0.39-0.93).

conclusionsWhen out-of-pocket medical bills from first childbirth are more than American families can afford to pay, they may postpone having a second child. This finding may be particularly true when childbirth medical bills are sent to debt collection agencies.

Indexed as

Health ExpendituresInsurance CoverageChildCohort StudiesFemaleHumansPennsylvaniaPovertyPregnancyUnited States

Identifiers

PMID32896469
PMCPMC7770019

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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.