Evidence map›Paper›PMID 35301259›Full record

ArticleBMJ quality & safety2022

Reduced rate of postpartum readmissions among homeless compared with non-homeless women in New York: a population-based study using serial, cross-sectional data.

Rie Sakai-Bizmark, Hiraku Kumamaru, Dennys Estevez, Sophia Neman, Lauren E M Bedel, Laurie A Mena, Emily H Marr, Michael G Ross

Open access · greenAbstract read
In one paragraph

Article in BMJ quality & safety, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.0field-weighted citation impact, top 12% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
  3. 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

8 authors at 3 institutions in 2 countries.

Rie Sakai-BizmarkThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA rsakaibizmark@ucla.edu.ORCID 0000-0003-2452-5832
Hiraku KumamaruDepartment of Healthcare Quality Assessment, The University of Tokyo School of Medicine, Tokyo, Japan.ORCID 0000-0002-9759-6191
Dennys EstevezThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.
Sophia NemanThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.ORCID 0000-0002-8345-9321
Lauren E M BedelThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.
Laurie A MenaThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.ORCID 0000-0003-3742-1434
Emily H MarrThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.ORCID 0000-0001-9086-6745
Michael G RossThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.ORCID 0000-0001-5500-404X
UCLA Medical Center · USUniversity of California, Los Angeles · USThe University of Tokyo · JP

Funding

Newborn Screening for Critical Congenital Heart Disease in U.S.: Assessment of implementation obstacles and application of cost-effectiveness to gauge if action needed for improved implementationK01HL141697 · NHLBI · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI SAKAI-BIZMARK, RIE · 2018 to 2022
$688k
NHLBI NIH HHS K01 HL141697
6 · The paper itself

Abstract

objectiveTo assess differences in rates of postpartum hospitalisations among homeless women compared with non-homeless women.

designCross-sectional secondary analysis of readmissions and emergency department (ED) utilisation among postpartum women using hierarchical regression models adjusted for age, race/ethnicity, insurance type during delivery, delivery length of stay, maternal comorbidity index score, other pregnancy complications, neonatal complications, caesarean delivery, year fixed effect and a birth hospital random effect.

settingNew York statewide inpatient and emergency department databases (2009-2014).

participants82 820 and 1 026 965 postpartum homeless and non-homeless women, respectively.

main outcome measuresPostpartum readmissions (primary outcome) and postpartum ED visits (secondary outcome) within 6 weeks after discharge date from delivery hospitalisation.

resultsHomeless women had lower rates of both postpartum readmissions (risk-adjusted rates: 1.4% vs 1.6%; adjusted OR (aOR) 0.87, 95% CI 0.75 to 1.00, p=0.048) and ED visits than non-homeless women (risk-adjusted rates: 8.1% vs 9.5%; aOR 0.83, 95% CI 0.77 to 0.90, p<0.001). A sensitivity analysis stratifying the non-homeless population by income quartile revealed significantly lower hospitalisation rates of homeless women compared with housed women in the lowest income quartile. These results were surprising due to the trend of postpartum hospitalisation rates increasing as income levels decreased.

conclusionsTwo factors likely led to lower rates of hospital readmissions among homeless women. First, barriers including lack of transportation, payment or childcare could have impeded access to postpartum inpatient and emergency care. Second, given New York State's extensive safety net, discharge planning such as respite and sober living housing may have provided access to outpatient care and quality of life, preventing adverse health events. Additional research using outpatient data and patient perspectives is needed to recognise how the factors affect postpartum health among homeless women. These findings could aid in lowering readmissions of the housed postpartum population.

Indexed as

Patient ReadmissionQuality of LifeCross-Sectional StudiesFemaleHumansInfant, NewbornNew YorkPostpartum PeriodPregnancyhealth services researchobstetrics and gynaecologywomens health

Identifiers

PMID35301259
PMCPMC9048168
OpenAlexW3167166304

What OpenQuestion holds

Textmetadata
LicenceTDM
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.