Evidence map›Paper›PMID 38574857›Full record

ArticleAmerican journal of obstetrics & gynecology MFM2024

Expanding comprehensive pregnancy care for Emergency Medicaid recipients: a cost-effectiveness analysis.

Kimberley A Bullard, Alyssa Hersh, Aaron B Caughey, Maria I Rodriguez

Open access · greenAbstract read
In one paragraph

Article in American journal of obstetrics & gynecology MFM, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 94% 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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

4 authors at 1 institution in 1 country.

Kimberley A BullardDepartment of Obstetrics and Gynecology, Center for Reproductive Health Equity, Oregon Health & Science University, Portland, OR (Drs Bullard, Hersh, Caughey, and Rodriguez); Department of Obstetrics and Gynecology, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN (Dr Bullard).
Alyssa HershDepartment of Obstetrics and Gynecology, Center for Reproductive Health Equity, Oregon Health & Science University, Portland, OR (Drs Bullard, Hersh, Caughey, and Rodriguez).
Aaron B CaugheyDepartment of Obstetrics and Gynecology, Center for Reproductive Health Equity, Oregon Health & Science University, Portland, OR (Drs Bullard, Hersh, Caughey, and Rodriguez).
Maria I RodriguezDepartment of Obstetrics and Gynecology, Center for Reproductive Health Equity, Oregon Health & Science University, Portland, OR (Drs Bullard, Hersh, Caughey, and Rodriguez). Electronic address: rodrigma@ohsu.edu.
Oregon Health & Science University · US

Funding

Examining the role of pregnancy coverage in preventing poor obstetric outcomes among Latina immigrantsR01MD013648 · NIMHD · OREGON HEALTH & SCIENCE UNIVERSITY · PI RODRIGUEZ, MARIA ISABEL · 2019 to 2023
$2.2M
NIMHD NIH HHS R01 MD013648
6 · The paper itself

Abstract

backgroundEmergency Medicaid is a restricted benefits program for individuals who have low-income status and who are immigrants.

objectiveThis study aimed to compare the cost-effectiveness of 2 strategies of pregnancy coverage for Emergency Medicaid recipients: the federal minimum of covering the delivery only vs extended coverage to 60 days after delivery. STUDY

designA decision analytical Markov model was developed to evaluate the outcomes and costs of these policies, and the results in a theoretical cohort of 100,000 postpartum Emergency Medicaid recipients were considered. The payor perspective was adopted. Health outcomes and cost-effectiveness over a 1- and 3-year time horizon were investigated. All probabilities, utilities, and costs were obtained from the literature. Our primary outcome was the incremental cost-effectiveness ratio of the competing strategies.

resultsExtending Emergency Medicaid to 60 days after delivery was determined to be a cost-saving strategy. Providing postpartum and contraceptive care resulted in 33,900 additional people receiving effective contraception in the first year and prevented 7290 additional unintended pregnancies. Over 1 year, it resulted in a gain of 1566 quality-adjusted life year at a cost of $10,903 per quality-adjusted life year. By 3 years of policy change, greater improvements were observed in all outcomes, and the expansion of Emergency Medicaid became cost saving and the dominant strategy.

conclusionThe inclusion of postpartum care and contraception for immigrant women who have low-income status resulted in lower costs and improved health outcomes.

Indexed as

Cost-Benefit AnalysisMedicaidQuality-Adjusted Life YearsAdultComprehensive Health CareCost-Effectiveness AnalysisEmigrants and ImmigrantsFemaleHumansMarkov ChainsPostnatal CarePovertyPregnancyPregnancy, UnplannedUnited StatescontraceptionEmergency Medicaidfederal- and state-funded coverageimmigrantnoncitizenpolicypostpartumpublicly fundeduninsuredunintended pregnancy

Identifiers

PMID38574857
PMCPMC11102284
OpenAlexW4393857858

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.