224548 Disparities in Pregnancy Outcomes by Payer Status in Hawaii: 2005-2009

Wednesday, November 10, 2010

Eric Hurwitz, PhD , Office of Public Health Studies, University of Hawaii, Honolulu, HI
Nancy S. Partika, RN, MPH , Office of Public Health Studies, University of Hawaii-Manoa, HPM Faculty, Honolulu, HI
Nandar Aung, MPH/MBA , Department of Public Health Sciences, University of Hawaii- Manoa, Honolulu, HI
Problem: Almost a third of Hawaii's births are to women on Medicaid/Quest, however little is known about how their maternal and child health (MCH) outcomes compare with privately-insured women, who represent just over half of all births. Study Purpose: An analysis on 88,000 Hawaii births was completed to (1) identify factors associated with insurance status (Med-Quest vs. private insurance) and (2) estimate the associations between insurance status (Med-Quest vs. private insurance) and MCH outcomes. This paper is the third of four analyzing labor and delivery data from Hawaii's birthing hospitals. Method: Hospital discharge data representing all births in Hawaii hospitals from January 1, 2005 through June 30, 2009 were linked (mother to baby), extracted, and analyzed. Descriptive and inferential statistics were computed on mother and newborn variables to identify factors and estimate associations. Findings: Compared to privately insured women, mothers who were on Med-Quest were more likely to be: living in a rural area, younger (15-24), of Native Hawaiian or “Other” ethnicity and to reside in certain counties. In terms of MCH outcomes, mothers on Med-Quest were more likely to: be diagnosed as substance-using or have a sexually transmitted disease (STD), have a newborn with a moderate to extreme newborn illness or have a pre-term singleton birth.

Implications: Findings confirm that there is a disparity in pregnancy outcomes by payer status in Hawaii. This study can be used to inform policymakers and assist in developing interventions to improve the outcomes of Med-Quest clients in Hawaii.

Learning Areas:
Advocacy for health and health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related public policy
Public health or related research

Learning Objectives:
By the end of this presentation, the learner will be able to: 1. Describe the difference found in women based on payer status (Medicaid/Quest and Private Payer) in Hawaii births from 2005-2009 2. Identify 2-3 variables that indicate disparities in pregnancy and birth outcomes in payer status of women giving birth in Hawaii from 2005-2009.

Keywords: Asian and Pacific Islander Women, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an associate professor of epidemiology, teach epidemiologic methods and analytic approaches to maternal and child health, conducted the data analysis for the project and co-wrote the abstract as part of a collaborative work group.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.