Evidence map›Paper›PMID 38677568›Full record

ArticleAnnals of epidemiology2024

Person-centered hospital discharge data: Essential existing infrastructure to enhance public health surveillance of maternal substance use disorders in the midst of a national maternal overdose crisis.

Rohan R D'Souza, Hannah Lf Cooper, Howard H Chang, Erin Rogers, Simone Wien, Sarah C Blake, Michael R Kramer

Open access · hybridAbstract read
In one paragraph

Article in Annals of epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
4.4field-weighted citation impact, top 7% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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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

7 authors at 1 institution in 1 country.

Rohan R D'SouzaEmory University Rollins School of Public Health, Biostatistics, USA.
Hannah Lf CooperEmory University, Department of Behavioral Sciences and Health Education, USA.
Howard H ChangEmory University Rollins School of Public Health, Biostatistics, USA.
Erin RogersEmory University Rollins School of Public Health, Epidemiology, USA.
Simone WienEmory University Rollins School of Public Health, Epidemiology, USA.
Sarah C BlakeRollins School of Public Health, Emory University, Health Policy & Management, USA.
Michael R KramerEmory University Rollins School of Public Health, Epidemiology, USA.
Emory University · US

Funding

The CORAL Training CoreU54HD113292 · NICHD · MOREHOUSE SCHOOL OF MEDICINE · PI Whitney Smith Rice, Dawn Tyus · 2023 to 2026
$9.8M
Risk Environments for Pregnant/Postpartum Women who Use Drugs: a longitudinal qualitative studyR01DA058065 · NIDA · EMORY UNIVERSITY · PI Hannah LF Cooper · 2023 to 2026
$2.7M
Training in Advanced Data Analytics to End Drug-Related Harms (TADA)T32DA050552 · NIDA · EMORY UNIVERSITY · PI Howard H Chang, Hannah LF Cooper · 2020 to 2026
$1.6M
NICHD NIH HHS U54 HD113292NIDA NIH HHS R01 DA058065NIDA NIH HHS T32 DA050552
6 · The paper itself

Abstract

objectivesAs crises of drug-related maternal harms escalate, US public health surveillance capacity remains suboptimal for drug-related maternal morbidities. Most state hospital discharge databases (HDDs) are encounter-based, and thus limit ascertainment of morbidities to delivery visits and ignoring those occurring during the 21 months spanning pregnancy and postpartum year. This study analyzes data from a state that curates person-centered HDD to compare patterns of substance use disorder (SUD) diagnoses at delivery vs. the full 21 pregnancy/postpartum months, overall and by maternal social position.

methodsAmong people who experienced an in-hospital birth in New York State between 9/1/2016 and 1/1/2018 (N = 330,872), we estimated SUD diagnosis (e.g., opioids, stimulants, benzodiazepines, cannabis) prevalence at delivery; across the full 9 months of pregnancy and 12 postpartum months; and by trimester and postpartum quarter. Risk ratio and risk difference estimated disparities by race/ethnicity, age, rurality, and payor.

resultsThe 21-month SUD prevalence rate per 100,000 was 2671 (95% CI 2616-2726), with 31% (29.5%-31.5%) missing SUD indication when ascertained at delivery only (1866; 95% CI 1820-1912). Quarterly rates followed a roughly J-shaped trajectory. Structurally marginalized individuals suffered the highest 21-month SUD prevalence (e.g., Black:White risk ratio=1.80 [CI:1.73-1.88]).

conclusionBy spanning the full 21 months of pregnancy/postpartum, person-centered HDD reveal than the maternal SUD crisis is far greater than encounter-based delivery estimates had revealed. Generating person-centered HDD will improve efforts to tailor interventions to help people who use drugs survive while pregnant and postpartum, and eliminate inequities.

Indexed as

Drug OverdosePatient DischargePregnancy ComplicationsSubstance-Related DisordersAdolescentAdultFemaleHumansNew YorkPostpartum PeriodPregnancyPrevalencePublic Health SurveillanceYoung AdultDataHospital dischargePostpartumPregnancySubstance Use DisorderSurveillance

Identifiers

PMID38677568
PMCPMC11423709
OpenAlexW4395677790

What OpenQuestion holds

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Registered trials

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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.