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Note: thesis: Thesis (M. P. H.)--Brown University, 2019
Genre (aat): theses
Abstract: PART I: The Relationship Between Health Insurance Type, Labor Induction and the Great Recession of 2008 Objective To study the impact that the U.S. economic recession (“Great Recession”) had on the association between health insurance type (Medicaid versus other types) and labor induction Study Design This is a retrospective, cross sectional study that utilized hospital discharge data from 2006 to 2014. The analytic sample consisted of 78,352 deliveries. Chi-squared analyses were performed to assess independence between insurance type (Medicaid versus other) and inductions for each year of interest. A multivariable logistic model assessed the relationship between health insurance type and labor induction. Additionally, a multivariable logistic model illustrated the association between the recession and induction, and was further stratified by insurance type. Results The years 2009, 2011 and 2013 had significantly more inductions for Medicaid recipients compared to non-Medicaid Recipients. Women enrolled in Medicaid as likely to be induced compared to non-Medicaid recipients after controlling for study covariates. However, in 2009 and 2010, women had 0.93 times the odds of being induced compared to 2006 and 2007. After stratifying by insurance type, women without Medicaid had significantly lower odds of being induced in 2009 and 2010 compared to 2006 and 2007. That relationship did not exist for Medicaid recipients. Conclusion This study found that the economic recession may have had an impact on likelihood of labor induction. PART II: The Relationship Between Health Insurance Type and Indications for Labor Induction Abstract Objective To study the relationship between health insurance type and indication for labor induction Study Design This is a retrospective, cross sectional study that utilized hospital discharge data and labor induction request forms. The analytic sample consisted of 4,553 labor inductions. A multinomial logistic model was created to assess the relationship between health insurance type and indication for labor induction. Results The majority of the labor inductions were performed for late term pregnancy, hypertensive disorders and premature rupture of membranes. Before adjusting for covariates, Medicaid recipients were more likely to be induced for a number of indications, including late term pregnancy and hypertensive disorders compared to non-Medicaid recipients. After adjusting for covariates, there were no differences in risk for indication by insurance type. Conclusion This study did not find any evidence to support that there is an association between health insurance type and primary indications for labor induction.
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01013657")
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00990332")
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01715839")
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Identifier: DOI: 10.26300/xm0z-px63
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