Abstract
Purpose
To examine the rate of timely postpartum screening for diabetes among Medicaid-eligible
women with gestational diabetes mellitus (GDM).
Methods
We examined a retrospective cohort of Medicaid women with a live birth between 2004
and 2007. Women with singleton live births at greater than 28 weeks gestation were
included in the cohort and their screening receipt tracked. Only the first qualifying
pregnancy within the observation period was assessed. Birth certificate records were
linked with hospital discharge data, outpatient prenatal care claims to identify women
with GDM (n = 6,239). Medicaid postpartum claims for these women were examined to determine receipt
of postpartum screening for diabetes within 5 to 13 weeks. Women with any indication
of a dedicated plasma glucose test identified by CPT codes 82947, 82950, 82951, and
82952 during this time period were considered to meet the definition of screening.
Results
Approximately 3.4% of women identified as having GDM were screened for diabetes postpartum.
Adjusted analysis found women not attending the postpartum visit (odds ratio [OR],
0.58; 95% confidence interval [CI], 0.37–0.91) and women receiving inadequate prenatal
care (OR, 0.57; 95% CI, 0.34–0.95) were less likely to receive postpartum screening
for diabetes. Conversely, women 20 to 34 years of age (OR, 1.79; 95% CI, 1.21–2.66)
and women who were obese (OR, 2.28; 95% CI, 1.56–3.32) were more likely to be screened.
Conclusions
Medicaid is a primary source of insurance for many women; however, for most coverage
ends at 60 days postpartum, leaving a narrow window of opportunity for postpartum
screening. Extended periods of coverage may be beneficial in ensuring the opportunity
to receive adequate postpartum care, including screening for diabetes.
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Biography
Nathan Hale, PhD, is a Research Assistant Professor in the Department of Health Services Policy and Management, University of South Carolina, Arnold School of Public Health. Research interests include Medicaid policy and systems of care for vulnerable populations.
Biography
Janice C. Probst, PhD, is a Professor in the Department of Health Services Policy and Management, University of South Carolina, Arnold School of Public Health. Research interests include rural heath and health care delivery systems for vulnerable populations.
Biography
Jihong Liu, ScD, is a Associate Professor in the Department of Epidemiology and Biostatistics at the University of South Carolina, Arnold School of Public Health. Research interests include obesity, chronic disease, and pregnancy.
Biography
Amy Brock Martin, DrPH, is a Research Assistant Professor in the Department of Health Services Policy and Management, University of South Carolina, Arnold School of Public Health. Research interests include Medicaid policy and access to care for vulnerable populations.
Biography
Kevin J. Bennett, PhD, is a Assistant Professor in the Department of Family and Preventive Medicine at the University of South Carolina School of Medicine. Research interests include with chronic disease and quality improvement.
Biography
Saundra Glover, PhD, is a Professor in the Department of Health Services Policy and Management at the University of South Carolina, Arnold School of Public Health. Research interests include health disparities and access to care for vulnerable populations.
Article info
Publication history
Published online: October 03, 2011
Accepted:
August 4,
2011
Received in revised form:
August 3,
2011
Received:
February 15,
2011
Identification
Copyright
© 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
