title: Healthcare Utilization in the Postpartum Period Among Illinois Women with Medicaid Paid Claims for Delivery, 2009-2010.
abstract: Purpose Postpartum care can provide the critical link between pregnancy and well-woman healthcare, improving women's health during the interconception period and beyond. However, little is known about current utilization patterns. This study describes the patterns of postpartum care experienced by Illinois women with Medicaid-paid deliveries. Methods Medicaid claims for women delivering infants in Illinois in 2009-2010 were analyzed for the receipt, timing and patterns of postpartum care, as identified through International Classification of Diseases Revision 9-Clinical Modification and Current Procedural Terminology© codes for routine postpartum care (43.4 % of visits), other postpartum services (e.g., depression screening, family planning), and other office visits for non-acute care. Results Over 90,000 visits to 55,577 women were identified, with 81.1 % of women experiencing any care during the first 90 days postpartum. Approximately 40 % had one visit, while 31 and 29 % had two and three or more visits, respectively. Thirty-four percent had their first visit <21 days postpartum, while 56 % had the first visit between 21 and 56 days postpartum. Compared with non-Hispanic whites, African-Americans had lower rates of receiving any care (73.6 vs. 86.5 %), fewer visits (48.0 vs. 33.5 % with only one visit), and later first visits (13.6 vs. 7.3 %, >56 days). Conclusions for Practice The vast majority of Illinois women with Medicaid-paid deliveries interact with the healthcare system during the first 3 months postpartum, though not always for a routine postpartum visit. Strategies to optimize postpartum health should encourage a higher level of coordination among services and linkage to well-woman care to improve subsequent women and infants' health outcomes.
authors.affiliation: Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, 1603 W. Taylor St. (m/c 923), Chicago, IL, 60612, USA. krankin@uic.edu.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Rankin
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
authors.forename: Sadia
authors.initials: S
authors.lastname: Haider
authors.affiliation: Department of Internal Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA.|Department of Pediatrics, University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Caskey
authors.affiliation: Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, 1603 W. Taylor St. (m/c 923), Chicago, IL, 60612, USA.
authors.forename: Apurba
authors.initials: A
authors.lastname: Chakraborty
authors.affiliation: Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Roesch
authors.affiliation: Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
authors.forename: Arden
authors.initials: A
authors.lastname: Handler
mesh_terms: D000067575:Administrative Claims, Healthcare / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007223:Infant; D008484:Medicaid / Q000706:statistics & numerical data*; D008483:Medical Assistance; D010342:Patient Acceptance of Health Care; D049590:Postpartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D014481:United States
keywords: Administrative claims data; Interconception care; Medicaid; Postpartum care