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首页> 外文期刊>Journal of women’s health >Antenatal Hospital Utilization Among Women at Risk for Disability
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Antenatal Hospital Utilization Among Women at Risk for Disability

机译：残疾风险妇女的产前医院利用

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Background: Little is known about the effect of potentially disabling health conditions on healthcare utilization during pregnancy. Using hospital discharge data, we identified women at risk for disability and evaluated antenatal hospital utilization, including emergency department (ED), observational stay (OS), and inpatient (IP) visits, by underlying health condition. Materials and Methods: Massachusetts Pregnancy to Early Life Longitudinal data system linked 2007-2009 birth certificates to 2006-2009 discharges. Access Risk Classification System categorized ICD-9-CM/Current Procedural Terminology codes recorded at delivery into disability risk groups (no/low vs. medium/high). Women were further categorized based on delivery diagnoses. Cox models evaluated the association between disability risk and utilization. Utilization by prenatal care and visit reason was examined. Results: Of 221,867 women, 4.0% were at medium/high risk of disability. Mental illness (26.9%) and circulatory system (25.2%) diagnoses were most common. More than 2% had comorbid mental/physical conditions. Women at risk for disability were more likely than women not at risk to have an antenatal ED (37.1% vs. 25.0%), OS (19.1% vs. 13.1%), or nondelivery IP visit (11.5% vs. 4.0%) (p0.001 for each). Utilization varied by diagnosis. In adjusted analyses, women with two or more physical conditions had highest rate of ED visit (hazard ratio [HR]=2.3, 95% confidence interval 1.8-2.8) and OS/IP visit (HR=2.9, 95% 2.3-3.6) compared with women not at risk. Inadequate prenatal care was associated with increased utilization across all disability risk groups. ED visits for mental illness were high across groups. Conclusions: Disability risk identified in discharge data is associated with elevated antenatal hospital utilization. Utilization varies by underlying diagnosis.
机译：背景：对怀孕期间潜在致残健康状况的影响几乎是众所周知的。使用医院放电数据，我们发现残疾风险和评估产前医院利用的妇女，包括急诊部门（ED），观察入住（OS）和住院病人（IP）访问，潜在的健康状况。材料与方法：马萨诸塞术妊娠早期纵向数据系统联系了2007 - 2009年的出生证书，达到2006 - 2009年。接入风险分类系统分类为在递送到残疾风险群体时记录的ICD-9-CM /当前程序术语代码（NO /低与中/高）。基于交付诊断，妇女进一步分类。 COX模型评估了残疾风险与利用之间的关联。研究了产前护理和访问原因的利用。结果：221,867名妇女，4.0％处于中/高风险。精神疾病（26.9％）和循环系统（25.2％）诊断最为常见。超过2％的患有型心理/物理条件。残疾风险的妇女比没有风险的妇女产生患有天然天性ED（37.1％vs.25.0％），OS（19.1％与13.1％）或Nondelivery IP访问（11.5％与4.0％）（每次p0.001）。利用因诊断而变化。在调整后的分析中，有两个或更多物理条件的女性具有最高的ED访问率（危险比[HR] = 2.3,95％置信区间1.8-2.8）和OS / IP访问（HR = 2.9,95％2.3-3.6）与没有风险的女性相比。产前护理不足与所有残疾风险群体的利用率增加有关。对精神疾病的访问跨群体很高。结论：排出数据中鉴定的残疾风险与升高的产前医院利用率有关。利用率因潜在诊断而异。

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