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, 24 (1), 30-38

Costs of Severe Maternal Morbidity During Pregnancy in US Commercially Insured and Medicaid Populations: An Observational Study

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Costs of Severe Maternal Morbidity During Pregnancy in US Commercially Insured and Medicaid Populations: An Observational Study

Kimberly K Vesco et al. Matern Child Health J.

Abstract

Objective: To estimate the maternity-related cost of health care services in women with and without severe maternal morbidity (SMM).

Methods: Women with a live inpatient birth in the calendar year 2013 were identified in the MarketScan® Commercial and Medicaid health insurance claims databases. Costs were defined as the amounts paid by insurers plus out-of-pocket and third-party payments. Costs were calculated as total maternity-related costs and categorized as prenatal, delivery, and postpartum costs. SMM was identified using the CDC algorithm of 25 ICD-9 diagnostic and procedural codes. Variables associated with higher delivery costs were determined by multivariable linear regression analysis.

Results: A total of 750 women met the criteria for SMM in the Commercial population. The total, per-patient mean costs of care for women without and with SMM were $14,840 and $20,380, respectively. Delivery hospitalization costs were 76-77% of total mean costs for women without and with SMM. A total of 99 women met the criteria for SMM in the Medicaid population. The total, per-patient mean costs of care for women without and with SMM were $6894 and $10,134, respectively. Delivery costs were 71-72% of total costs. Variables independently predictive of increased delivery costs in both Commercial and Medicaid populations were delivery by cesarean section, multifetal gestation, gestational hypertension/preeclampsia, and obstetric infection.

Conclusions: The occurrence of SMM was associated with an increase in maternity-related costs of 37% in the Commercial and 47% in the Medicaid population. Some of the factors associated with increased delivery hospitalization costs may be prevented.

Keywords: Comorbidity; Health care costs; Hospitalization; Insurance claim review; Pregnancy complications; United States.

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References

    1. J Womens Health (Larchmt). 2008 Oct;17(8):1279-84 - PubMed

References

    1. NCHS Data Brief. 2010 Mar;(35):1-8 - PubMed

References

    1. Obstet Gynecol. 2012 Nov;120(5):1029-36 - PubMed

References

    1. Matern Child Health J. 2008 Jul;12(4):469-77 - PubMed

References

    1. Am J Obstet Gynecol. 2016 Oct;215(4):509.e1-6 - PubMed

References

    1. Am J Obstet Gynecol. 2014 May;210(5):435.e1-8 - PubMed

References

    1. Natl Vital Stat Rep. 2015 Dec;64(12):1-64 - PubMed

References

    1. Med Care. 2009 Oct;47(10):1046-52 - PubMed

References

    1. Am J Obstet Gynecol. 2013 Dec;209(6):586.e1-586.e11 - PubMed

References

    1. J Womens Health (Larchmt). 2015 Nov;24(11):924-32 - PubMed

References

    1. Am J Obstet Gynecol. 2016 May;214(5):643.e1-643.e10 - PubMed

References

    1. Am J Obstet Gynecol. 2016 Jan;214(1):122.e1-7 - PubMed

References

    1. Med Care. 2010 May;48(5):487-93 - PubMed

References

    1. Am J Obstet Gynecol. 2014 Dec;211(6):698.e1-11 - PubMed

References

    1. Obstet Gynecol. 2013 Sep;122(3):627-33 - PubMed

References

    1. Womens Health Issues. 2007 Jan-Feb;17(1):13-21 - PubMed

References

    1. Paediatr Perinat Epidemiol. 2012 Nov;26(6):497-505 - PubMed

References

    1. Obstet Gynecol. 2015 Jun;125(6):1460-7 - PubMed

References

    1. BMC Pregnancy Childbirth. 2011 Oct 04;11:67 - PubMed

References

    1. Obstet Gynecol. 2008 May;111(5):1089-95 - PubMed

References

    1. J Med Econ. 2015;18(7):533-41 - PubMed

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