ArticleHealth services research2024
Insurance coverage and discontinuity during pregnancy: Frequency and associations documented in the PROMISE cohort.
Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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
9 citing papers in PubMed, 12 citations in OpenAlex.
- Association of trimester-specific gestational weight gain with child BMI by maternal BMI categories in community-based healthcare organizations.International journal of obesity (2005) · 2026Article
- Validation of pregnancy date estimation from outpatient electronic health record data.JAMIA open · 2026Article
- Gestational weight change patterns in pregnant people with obesity class I, II, and III receiving care from community-based health care centers.Annals of epidemiology · 2025Article
- Early Infancy Weight Gain Patterns Are Associated with Child Body Mass Index in Singletons but Not Twins.The Journal of pediatrics · 2025Article
- Early childhood weight trajectory differences in twins, singletons, and gestational-age matched singletons.Preventive medicine reports · 2025Article
- Methods for modeling gestational weight gain: empirical application using electronic health record data from a safety net population.BMC pregnancy and childbirth · 2025Article
- Trimester-specific rate of gestational weight loss or gain and birth size: differences by prepregnancy BMI.Obesity (Silver Spring, Md.) · 2024Article
- Insurance coverage and discontinuity during pregnancy: Frequency and associations documented in the PROMISE cohort.Health services research · 2024Article
- Pregnancy health in a multi-state U.S. population of systemically underserved patients and their children: PROMISE cohort design and baseline characteristics.BMC public health · 2024Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo describe insurance patterns and discontinuity during pregnancy, which may affect the experiences of the pregnant person: their timely access to care, continuity of care, and health outcomes. DATA SOURCES AND STUDY
settingData are from the PROMISE study, which utilizes data from community-based health care organizations (CHCOs) (e.g., federally qualified health centers that serve patients regardless of insurance status or ability to pay) in the United States from 2005 to 2021. STUDY
designThis descriptive study was a cohort utilizing longitudinal electronic health record data. DATA COLLECTION/EXTRACTION
methodsInsurance type at each encounter was recorded in the clinical database and coded as Private, Public, and Uninsured. Pregnant people were categorized into one of several insurance patterns. We analyzed the frequency and timing of insurance changes and care utilization within each group. PRINCIPAL
findingsContinuous public insurance was the most common insurance pattern (69.2%), followed by uninsured/public discontinuity (11.8%), with 6.4% experiencing uninsurance throughout the entirety of pregnancy. Insurance discontinuity was experienced by 16.6% of pregnant people; a majority of these reflect people transitioning to public insurance. Those with continuous public insurance had the highest frequency of inadequate prenatal care (19.5%), while those with all three types of insurance during pregnancy had the highest percentage of intensive prenatal care (16.5%). The majority (71.7%-81.2%) of those with a discontinuous pattern experienced a single insurance change.
conclusionsInsurance discontinuity and uninsurance are common within our population of pregnant people seeking care at CHCOs. Our findings suggest that insurance status should be regarded as a dynamic rather than a static characteristic during pregnancy and should be measured accordingly. Future research is needed to assess the drivers of perinatal insurance discontinuity and if and how these discontinuities may affect health care access, utilization, and birth outcomes.
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