272512 Preconception Mental Health Status and Pregnancy-Related Healthcare Use and Expenditures in the US

Monday, October 29, 2012 : 11:30 AM - 11:50 AM

Whitney P. Witt, PhD, MPH , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Lauren E. Wisk, BS , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Kara Mandell, MA , Department of Population Health, University of Wisconsin-Madison, Madison, WI
Erika Rose Cheng, MPA , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Angela Forgues , Department of Population Health Sciences, University of Wisconsin, Madison, Madison, WI
Background: We examined if and to what extent women's preconception mental health status impacted subsequent pregnancy-related healthcare use and expenditures.

Methods: We examined 4,084 women using data from the 1996-2006 Medical Expenditure Panel Survey (MEPS), a national, population-based panel survey. Preconception mental health was defined as women's poor mental health before conception. Data included emergency room, inpatient, and office-based and outpatient healthcare use and expenditures from the MEPS Household Event Files. Mean healthcare use and expenditures were estimated using a two-part model and confidence intervals were estimated using bootstrapping techniques to replicate analyses 1000 times.

Results: 8.4% of pregnant women reported poor mental health prior to pregnancy. Women with poor preconception mental health were significantly more likely to have pregnancy-related ER visits and higher expenditures ($22.08 more in total expenditures and $204.20 more in total charges), controlling for confounders. In contrast, women who reported poor preconception mental health had significantly fewer office based and outpatient pregnancy-related visits (7.86 versus 9.15 for women in good preconception mental health) and expenditures. These women also had fewer pregnancy-related inpatient stays and lower expenditures associated with inpatient stays.

Conclusion: Preconception mental health status predicts the setting in which women receive and the expenditures associated with pregnancy-related healthcare services. Accordingly, healthcare providers in both emergency and non-emergency settings should strive to identify and treat women's preconception mental health problems in an effort to optimize pregnancy-related healthcare use and improve the survival, long-term health, quality of life, and well-being of children and their mothers.

Learning Areas:
Biostatistics, economics
Public health or related research

Learning Objectives:
By the end of this session, the participants will be able to Describe the impact of preconception mental health status and pregnancy-related healthcare use and expenditures in the US;

Keywords: Mental Health, Healthcare Costs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student at the University of Wisconsin-Madison. I assisted with the conceptualization and writing of the presentation.
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.