Socioeconomic, Racial, and Ethnic Disparities in Postpartum Readmissions in Patients with Preeclampsia: a Multi-state Analysis, 2007-2014.

TitleSocioeconomic, Racial, and Ethnic Disparities in Postpartum Readmissions in Patients with Preeclampsia: a Multi-state Analysis, 2007-2014.
Publication TypeJournal Article
Year of Publication2019
AuthorsWagner JL, White RS, Tangel V, Gupta S, Pick JS
JournalJ Racial Ethn Health Disparities
Volume6
Issue4
Pagination806-820
Date Published2019 Aug
ISSN2196-8837
Abstract

PURPOSE: Childbirth is the most common reason for hospitalization for reproductive-aged women, with about 4 million annual deliveries nationally. Hypertension is the leading indication for postpartum readmission and therefore women with preeclampsia are at high risk for readmission. Social determinants of health are associated with increased readmission in postpartum patients; however, no study has specifically investigated readmissions in this higher risk group of patients. We sought to evaluate the effect of social determinants of health on postpartum readmissions in all postpartum patients and in a subgroup analysis of those with a diagnosis of preeclampsia.

METHODS: We conducted a retrospective (2007-2014) analysis of all singleton deliveries in Florida, California, New York, and Maryland from the State Inpatient Databases, Healthcare Cost and Utilization Project. Primary outcomes were readmission at 30 days after delivery. Descriptive statistics were calculated, and multivariate regression analysis was used to estimate the adjusted odds ratio (OR) for readmissions. Subgroup analysis was performed on preeclampsia patients only. Statistical significance was evaluated at the < 0.05 alpha level.

RESULTS: A total of 4,999,993 patients were included in our analysis. Among all postpartum patients and in subgroup analysis for preeclampsia patients only, readmission rates are higher for black patients, patients in the poorest quartile of median income, and patients with public insurance (Medicare or Medicaid).

CONCLUSIONS: The present study has shown that socioeconomic and racial/ethnic disparities exist in postpartum readmissions. These findings additionally exist among the already highest-risk preeclamptic patients. Future research should further elucidate this relationship and develop amelioration strategies.

DOI10.1007/s40615-019-00580-1
Alternate JournalJ Racial Ethn Health Disparities
PubMed ID30887426

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