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Rural/urban differences in health care utilization and costs by perinatal depression status among commercial enrollees
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1 2024
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Source: J Rural Health. 40(1):26-63
Details:
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Alternative Title:J Rural Health
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Personal Author:
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Description:Purpose:
To understand differences in health care utilization and medical expenditures by perinatal depression (PND) status during pregnancy and 1-year postpartum overall and by rural/urban status.
Methods:
We estimated differences in health care utilization and medical expenditures by PND status for individuals with an inpatient live-birth delivery in 2017, continuously enrolled in commercial insurance from 3 months before pregnancy through 1-year postpartum (study period), using MarketScan Commercial Claims data. Multivariable regression was used to examine differences by rurality.
Findings:
Ten percent of commercially insured individuals had claims with PND. A smaller proportion of rural (8.7%) versus urban residents (10.0%) had a depression diagnosis (p < 0.0001). Of those with PND, a smaller proportion of rural (5.5%) versus urban residents (9.6%) had a depression claim 3 months before pregnancy (p < 0.0001). Compared with urban residents, rural residents had greater differences by PND status in total inpatient days (rural: 0.7, 95% confidence interval [CI]: 0.6–0.9 vs. urban: 0.5, 95% CI: 0.5–0.6) and emergency department (ED) visits (rural: 0.7, 95% CI: 0.6–0.9 vs. urban: 0.5, 95% CI: 0.4–0.5), but a smaller difference by PND status in the number of outpatient visits (rural: 9.2, 95% CI: 8.2–10.2 vs. urban: 13.1, 95% CI: 12.7–13.5). Differences in expenditures for inpatient services by PND status differed by rural/urban status (rural: $2654; 95% CI: $1823–$3485 vs. urban: $1786; 95% CI: $1445-$2127).
Conclusions:
Commercially insured rural residents had more utilization for inpatient and ED services and less utilization for outpatient services. Rural locations can present barriers to evidence-based care to address PND.
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Source:
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Pubmed ID:37467110
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Pubmed Central ID:PMC10796846
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Document Type:
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Funding:
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Volume:40
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Issue:1
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