Effect of Insurance Status on the Length of Time to Readmission for Postpartum Preeclampsia [ID: 1377910

Abstract

INTRODUCTION: Maternal statistics show us that the majority of maternal morbidity and mortality occur postpartum, with a higher rate of morbidity and mortality in those without private insurance. Hypertensive disorders of pregnancy remain a significant cause of pregnancy-related death, and preeclampsia was found to account for 82% of the readmissions at our community-based hospital. Timely diagnosis of preeclampsia can prevent further morbidity and mortality. A retrospective cohort study was conducted to determine whether insurance status has an effect on length of time until diagnosis of preeclampsia requiring postpartum readmission. METHODS: All patients with deliveries and postpartum readmissions from January 1, 2018 to December 31, 2020, were included in the study at Saint Peters University Hospital in New Brunswick, New Jersey, with IRB approval. Data were obtained from the Paragon Electronic Medical Record, including the patient insurance status (private or service-Medicaid, Medicaid HMO, self-pay), race, ethnicity, age, length of admission and readmission, as well as length of time between the delivery admission to readmission. Institutional board review committee approval was obtained for this study. RESULTS: A total of 15,509 patients were delivered between 2018 and 2020 with 149 (0.96%; 149/15,509) patients readmitted for hypertensive disorders of pregnancy. The study showed that patients with private insurance were readmitted on average in 4.54+3.42 days after their delivery admission, whereas those without private insurance were admitted on average 6.30+4.91 days after delivery admission (P=.010). CONCLUSION: In this community-based hospital, patients with private insurance who were readmitted for preeclampsia were diagnosed and readmitted for treatment in a shorter period of time than those without private insurance.