The Effects of Medicaid Policy Interventions on Severe Maternal Morbidity
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 10,000,000
- 试验地点
- 2
- 主要终点
- Severe maternal morbidity (SMM)
研究概览
简要总结
The goal of this study is to learn about the effects of Medicaid policy interventions on severe maternal morbidity (SMM) and mortality and maternal health. The main questions it aims to answer are:
- What is the effect of Medicaid healthcare quality interventions on SMM?
- What is the effect of Medicaid healthcare quality interventions + doula care?
- What are Medicaid beneficiaries' experiences in receiving services and the potential impact of integration of doula services?
Participants will be asked to describe experiences as a result of Medicaid policy interventions and focused Medicaid policies.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Factorial
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Pregnant and postpartum Medicaid beneficiaries across the US
- •Qualitative:
- •Medicaid beneficiaries who identify as being at risk for poor outcomes or live in PA Health Equity Zones
- •Doulas who provide care to Medicaid beneficiaries in Pennsylvania
- •Medicaid Managed Care Organization (MCO) administrators in Pennsylvania. Severe maternal morbidity and mortality outcomes will be assessed in healthcare records and for these quantitative outcomes, patients will not be recruited individually
排除标准
- 未提供
研究组 & 干预措施
Doula Only
The investigators will test two hypotheses: H1: SMM rates will decline among populations at risk after the addition of doula care in PA, relative to healthcare quality interventions alone. H2: SMM will decline more among those exposed to both healthcare quality and doula care interventions in PA, relative to states implementing doula care only. The investigators will collect qualitative data to assess the effects of the Medicaid healthcare and service interventions on beneficiaries' experiences.
干预措施: Doula (Behavioral)
Doula Only
The investigators will test two hypotheses: H1: SMM rates will decline among populations at risk after the addition of doula care in PA, relative to healthcare quality interventions alone. H2: SMM will decline more among those exposed to both healthcare quality and doula care interventions in PA, relative to states implementing doula care only. The investigators will collect qualitative data to assess the effects of the Medicaid healthcare and service interventions on beneficiaries' experiences.
干预措施: Standard Care (Behavioral)
Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) Only
The investigators will employ a quasi-experimental study design to test two hypotheses: H1: SMM rates will decline among populations at risk after the interventions (incentive payment and obstetric bundled payment) within Pennsylvania (PA); and H2: SMM will decline among those exposed to the interventions in PA, relative to those in similar states. The investigators will collect qualitative data to assess the effects of the Medicaid healthcare interventions on beneficiaries' experiences.
干预措施: Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) (Behavioral)
Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) Only
The investigators will employ a quasi-experimental study design to test two hypotheses: H1: SMM rates will decline among populations at risk after the interventions (incentive payment and obstetric bundled payment) within Pennsylvania (PA); and H2: SMM will decline among those exposed to the interventions in PA, relative to those in similar states. The investigators will collect qualitative data to assess the effects of the Medicaid healthcare interventions on beneficiaries' experiences.
干预措施: Standard Care (Behavioral)
Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) + Doula
干预措施: Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) (Behavioral)
Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) + Doula
干预措施: Doula (Behavioral)
Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) + Doula
干预措施: Standard Care (Behavioral)
Standard Care
结局指标
主要结局
Severe maternal morbidity (SMM)
时间窗: 20 weeks gestation through 42 days postpartum
SMM rate based on the Centers for Disease Control algorithm
次要结局
- Medicaid managed care administrator perspectives on policy interventions(Year 3)
- Follow up for chronic conditions(43 days through 1 year after delivery)
- Provision of evidence care in pregnancy and postpartum(During pregnancy and postpartum up to 1 year)
- All cause mortality(Delivery date through one year after delivery)
研究者
Dara Mendez
Associate Professor
University of Pittsburgh