UNASSIGNED: Data sources comprised Michigan Medicaid administrative claims and Phase 7 Michigan Pregnancy Risk Assessment Monitoring System (MI-PRAMS) survey responses, linked at the individual level. Participants were continuously enrolled in Michigan Medicaid, delivered a live birth (2012-2015), responded to the survey, and screened positive for PMAD symptoms on the adapted two-item Patient Health Questionnaire. Unadjusted and adjusted weighted logistic regression analyses were used to predict the likelihood of having a PMAD diagnosis (for the overall sample and stratified by race).
UNASSIGNED: The weighted analytic cohort represented 24,353 deliveries across the 4-year study. Only 19.8% of respondents with symptoms of PMAD had a PMAD diagnosis between delivery and 3 months afterward. Black respondents were less likely to have PMAD diagnoses (adjusted odds ratio [AOR]=0.23, 95% CI=0.11-0.49) compared with White respondents. Among White respondents, no covariates were significantly associated with having a diagnosis. However, among Black respondents, more comorbid conditions and more life stressors were statistically significantly associated with having a diagnosis (AOR=3.18, 95% CI=1.27-7.96 and AOR=3.12, 95% CI=1.10-8.88, respectively).
UNASSIGNED: Rate of PMAD diagnosis receipt differed by race and was low overall. Black respondents were less likely than White respondents to receive a diagnosis. Patient characteristics influencing diagnosis receipt also differed by race, indicating that strategies to improve detection of these disorders require a tailored approach.
■数据来源包括密歇根州医疗补助行政索赔和7期密歇根州妊娠风险评估监测系统(MI-PRAMS)调查答复。联系在个人层面。参与者连续参加密歇根医疗补助,分娩活产(2012-2015),对调查的回应,并在适应的两项患者健康问卷中筛选出PMAD症状阳性。使用未调整和调整的加权逻辑回归分析来预测具有PMAD诊断的可能性(对于总体样本和按种族分层)。
■加权分析队列代表了4年研究中的24,353例分娩。只有19.8%的有PMAD症状的受访者在分娩至3个月后有PMAD诊断。与白人受访者相比,黑人受访者不太可能有PMAD诊断(调整后比值比[AOR]=0.23,95%CI=0.11-0.49)。在白人受访者中,没有协变量与诊断显著相关.然而,在黑人受访者中,更多的合并症和更多的生活压力源与诊断有统计学显著相关(分别为AOR=3.18,95%CI=1.27-7.96和AOR=3.12,95%CI=1.10-8.88).
■PMAD诊断接诊率因种族而异,总体较低。黑人受访者比白人受访者不太可能接受诊断。影响诊断接收的患者特征也因种族而异,这表明改善这些疾病检测的策略需要量身定制的方法。