Estimating the Hospital Delivery Costs Associated With Severe Maternal Morbidity in New York City, 2008–2012

Howland, Renata E.; Angley, Meghan; Won, Sang Hee; Wilcox, Wendy; Searing, H; Tsao, Tsu-Yu

doi:10.1097/aog.0000000000002432

Cited by 21 publications

(15 citation statements)

References 15 publications

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“…In contrast, the NIS and NYC studies analyzed mixed populations of commercially insured and Medicaid patients (the former 50% Commercial and 44% Medicaid patients and the latter 38% Commercial and 58% Medicaid patients). 14 , 15 In addition, the earlier studies used an algorithm for identifying SMM based on ICD-9 codes, whereas the present study was based on ICD-10 codes. 14–16 …”

Section: Discussionmentioning

confidence: 98%

“…Two earlier studies reported delivery hospitalization costs associated with SMM, using, respectively, discharge data from the 2011 National Inpatient Sample (NIS) and a dataset of all delivery hospitalizations in New York City (NYC) from 2008 to 2012. 14 , 15 Direct comparison of these delivery cost estimates with estimates based on reimbursements in separate Commercial and Medicaid populations is difficult, given the different population structures and cost data sources. The earlier analyses estimated the costs expended by the hospital but excluded physician expenses.…”

Section: Discussionmentioning

confidence: 99%

“…13 In studies based on hospital discharge records, mean delivery costs (not including prenatal and postdelivery costs) associated with SMM were estimated to be about twice those of deliveries without SMM. 14 , 15 …”

Section: Introductionmentioning

confidence: 99%

“… 16 However, in these previously reported studies, SMM was identified using the Centers for Disease Control and Prevention (CDC) list of 25 indicators, based on the International Classification of Diseases, 9th edition (ICD-9) codes. 14–16 In 2017 the CDC algorithm for SMM was revised from 25 indicators to include a list of 21 indicators based on ICD-10 codes. 13 The incidence of SMM in nationwide samples of commercially and Medicaid-insured women using the revised CDC algorithm for SMM has been reported recently and found the incidence to be 111.4 in the Commercial and 109.6 per 10,000 deliveries in the Medicaid population.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Costs of Severe Maternal Morbidity in U.S. Commercially Insured and Medicaid Populations: An Updated Analysis

Black

Vesco

Mehta

et al. 2021

Women's Health Reports

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Background: The most common reason for hospitalization in the United States is childbirth. The costs of childbirth are substantial. Materials and Methods: This was a retrospective cohort study of hospital deliveries identified in the MarketScan ® Commercial and Medicaid health insurance claim databases. Women with an inpatient birth in the calendar year 2016 were included. Severe maternal morbidity (SMM) was identified using the Centers for Disease Control and Prevention algorithm of 21 International Classification of Diseases-10 codes. Mean costs and cost ratios for women with and without SMM were reported. Generalized linear models were used to analyze demographic and clinical variables influencing delivery costs. Results: We identified 1,486 women in the Commercial population, who had a birth in 2016 and met the criteria for SMM. The total mean per-patient costs of care for women with and without SMM were $50,212 and $23,795, respectively. In the Medicaid population there were 29,763 births, of which 342 met the criteria for SMM. The total mean per-patient costs of care for women with and without SMM were $26,513 and $9,652, respectively. A multifetal gestation, a cesarean delivery, maternal age, and pregnancy-related complications were independently predictive of increased delivery costs in both Commercial and Medicaid populations. Conclusions: The occurrence of SMM was associated with an increase in maternity-related costs of 111% in the Commercial and 175% in the Medicaid population. Some of the factors associated with increased delivery hospitalization costs could be treated or avoided.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Costs of Severe Maternal Morbidity in U.S. Commercially Insured and Medicaid Populations: An Updated Analysis

Black

Vesco

Mehta

et al. 2021

Women's Health Reports

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“…1 A population-based cross-sectional study on New York City deliveries demonstrated that severe maternal morbidity almost doubled the cost of delivery and, furthermore, resulted in approximately $83 million in excess over five years. 2 Recently, there has been many models and algorithms developed and tested in order to screen early for disease processes in obstetrics that lead to morbidity in hopes of providing early interventions. A systematic review found 17 studies on prediction models for gestational diabetes.…”

Section: Introductionmentioning

confidence: 99%

A Novel and Precise Profiling Tool to Predict Gestational Diabetes

McLaren

Haberman

Moscu³

et al. 2020

J Diabetes Sci Technol

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Background: There is a trend in healthcare for developing models for predictions of disease to enable early intervention and improve outcome. Instrument: We present the use of artificial intelligence algorithms that were developed by Gynisus Ltd. using mathematical algorithms. Experience: Data were retrospectively collected on pregnant women that delivered at a single institution. Hundreds of parameters were collected and found to have different importance and correlation with the likelihood to develop gestational diabetes mellitus (GDM). We highlight 3 of 29 specific parameters that were important in pregestation and in early pregnancy, which have not been previously correlated with GDM. Conclusion: This predictive tool identified parameters that are not currently being used as predictors in GDM, even before pregnancy. This tool opens the possibility of intervening on patients identified at risk for GDM and its complications. Future prospective studies are needed.

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The association between race/ethnicity and peripartum hysterectomy and the risk of perioperative complications

Lawson

Chou

Martin

et al. 2020

Intl J Gynecology & Obste

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Objective To compare perioperative outcomes by patient race/ethnicity. Methods A retrospective cohort study identified 7 331 638 childbirth hospitalizations for women aged 12–55 years in the USA between 2004–2014. Peripartum hysterectomy, in‐hospital mortality, perioperative complications, length of stay, and cost of hysterectomy data were analyzed using SAS. Results Among childbirth hospitalizations (52.9% white, 13.5% black, 23.0% Hispanic, 5.2% Asian, and 5.4% other), peripartum hysterectomy occurred in 6619. The incidence of peripartum hysterectomy was 90.3 (95% confidence interval [CI] 87.7–93.0) per 100 000 hospitalizations, and higher for black (111.0, 95% CI 104.5–117.4), Hispanic (104.9, 95% CI 99.1–110.8), and Asian women (119.6, 95% CI 109.1–130.2) compared to whites (75.7, 95% CI 72.8–78.5). After adjustment, Hispanic women had an 18% higher odds of undergoing peripartum hysterectomy (odds ratio [OR] 1.18, 95% CI 1.08–1.29; P=0.004) than white women. Non‐white women had a 2–3‐fold higher odds of in‐hospital mortality (ORblack 2.76, 95% CI 1.44–5.30; ORHispanic 1.99, 95% CI 1.04–3.82; ORAsian+other 2.44, 95% CI 1.11–5.40. Black and Asian/other women were more likely to undergo blood transfusions. Conclusion Women of color have higher rates of peripartum hysterectomy and experience higher rates of poor perioperative outcomes and mortality.

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Estimating the Hospital Delivery Costs Associated With Severe Maternal Morbidity in New York City, 2008–2012

Cited by 21 publications

References 15 publications

Costs of Severe Maternal Morbidity in U.S. Commercially Insured and Medicaid Populations: An Updated Analysis

Costs of Severe Maternal Morbidity in U.S. Commercially Insured and Medicaid Populations: An Updated Analysis

A Novel and Precise Profiling Tool to Predict Gestational Diabetes

The association between race/ethnicity and peripartum hysterectomy and the risk of perioperative complications

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