Racial disparities in economic and clinical outcomes of pregnancy among medicaid recipients

Shun Zhang, Kathryn Cardarelli, Ruth Shim, Jiali Ye, Karla L. Booker, George Rust

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hospital and to incur higher Medicaid costs. African-American women were also more likely to experience preeclampsia, placental abruption, preterm birth, small birth size for gestational age, and fetal death/stillbirth. Eliminating racial disparities in adverse pregnancy outcomes (not counting infant costs), could generate Medicaid cost savings of 114 to 214 million per year in these 14 states. Despite having the same insurance coverage and meeting the same poverty guidelines for Medicaid eligibility, African American women have a higher rate of adverse pregnancy outcomes than White or Hispanic women. Racial disparities in adverse pregnancy outcomes not only represent potentially preventable human suffering, but also avoidable economic costs. There is a significant financial return-on-investment opportunity tied to eliminating racial disparities in birth outcomes. With the Affordable Care Act expansion of Medicaid coverage for the year 2014, Medicaid could be powerful public health tool for improving pregnancy outcomes.

Original languageEnglish (US)
Pages (from-to)1518-1525
Number of pages8
JournalMaternal and Child Health Journal
Volume17
Issue number8
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

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Medicaid
Pregnancy Outcome
Economics
African Americans
Costs and Cost Analysis
Parturition
Patient Protection and Affordable Care Act
Abruptio Placentae
Insurance Coverage
Fetal Death
Stillbirth
Cost Savings
Premature Birth
Poverty
Pre-Eclampsia
Psychological Stress
Hispanic Americans
Ethnic Groups
Cesarean Section
Gestational Age

Keywords

  • Adverse maternal-child health outcomes and eliminating disparities
  • Disparities
  • Economic burden
  • Medicaid

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology
  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Racial disparities in economic and clinical outcomes of pregnancy among medicaid recipients. / Zhang, Shun; Cardarelli, Kathryn; Shim, Ruth; Ye, Jiali; Booker, Karla L.; Rust, George.

In: Maternal and Child Health Journal, Vol. 17, No. 8, 01.01.2013, p. 1518-1525.

Research output: Contribution to journalArticle

Zhang, Shun ; Cardarelli, Kathryn ; Shim, Ruth ; Ye, Jiali ; Booker, Karla L. ; Rust, George. / Racial disparities in economic and clinical outcomes of pregnancy among medicaid recipients. In: Maternal and Child Health Journal. 2013 ; Vol. 17, No. 8. pp. 1518-1525.
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