UROP Fellowship: WAGSFP
Research Mentor(s): Lindsay Admon, MD, MSc
Research Mentor Institution/Department: Michigan Medicine, Departments of Obstetrics and Gynecology
Presentation Date: Wednesday, August 4th
Session: Session 2 (4pm-4:50pm EDT)
Breakout Room: Room 2
“Objective: To provide updated estimates on patterns of health insurance coverage at preconception, birth, and postpartum and to examine differences among rural compared with urban residents.
Methods: We conducted a cross-sectional analysis of survey data from 104, 994 individuals in 42 jurisdictions (40 states, New York City, and Puerto Rico) participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2016-2018. The PRAMS data includes identification of health insurance status at preconception, birth, and postpartum. We calculated unadjusted estimates of insurance coverage (hierarchically classified as Private, Medicaid, and uninsured) status at these time points for all mothers and conducted subgroup analyses among rural compared with urban residents. All analyses were survey-weighted and conducted in STATA, version 16.0.
Results: We found that in 2016-2018, overall rates of uninsurance were the highest in the preconception period (13.4%, 95% CI 13.1-13.8) and the lowest at delivery (3.3%, 95% CI 3.1-3.5). At all three perinatal time points, rural residents experienced higher rates of uninsurance compared to urban residents. Medicaid coverage was the highest at birth (41.4%, 95% CI 40.9-41.9) and the lowest in the preconception period (22.2%, 95% CI 21.9-22.6). Rural residents experienced higher rates of Medicaid coverage at both timepoints.
Conclusion: Higher rates of uninsurance in the perinatal period were identified among rural compared to urban residents. To inform policy solutions for improving insurance coverage levels among rural individuals, future work should examine disparities among rural residents by race/ethnicity, income, and state of residence. ”
Authors: Maya Millette; Katy B. Kozhimannil, PhD, MPA; Julia Interrante, MPH; Jamie R. Daw, PhD; Lindsay K. Admon, MD, MSc
Research Method: Data Collection and Analysis