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Disparities in the provision of perinatal care based on patient race in the United States.
- Source :
-
Birth: Issues in Perinatal Care . Sep2023, Vol. 50 Issue 3, p627-635. 9p. - Publication Year :
- 2023
-
Abstract
- Background: In the United States, there are significant health inequities in perinatal care. This study examined differences in perinatal care provided to women based on the birthing person's designated race, within a large and diverse cohort of women. Methods: This retrospective electronic medical record review identified patients receiving perinatal care within a large hospital system between January 2012 and September 2018 and examined associations between maternal designated race/ethnicity (Hispanic or nonāHispanic [NH] Black, Asian or White) and various provider treatment decisions. Results: The study sample (N = 7056) was comprised of 36% Hispanic, 34% NH White, 21% NH Black, and 4% NH Asian women, aged 29.7 ± 6.3 years; 53% of the sample had private insurance, and 45% had Medicaid. Few differences by race were seen in perinatal care based on guidelines or expert recommendations (nondiscretionary care). Discretionary care, however, varied by race: Compared with NH White women, NH Black women were less likely to receive a prenatal depression screen (OR 0.8 [95% CI: 0.7, 0.9]) and more likely to have a urine drug test when denying drug use (OR 1.6 [95% CI 1.3, 2.0]), whereas Hispanic (OR 0.6 [95% CI: 0.5, 0.8]) and NH Asian (0.4 [95% CI 0.2, 0.9]) women were less likely to have a urine drug test completed when denying drug use. Discussion: Perinatal care differs by maternal race/ethnicity, particularly when guidelines or expert recommendations are absent. Greater efforts need to be made to identify and mitigate providers' implicit and explicit biases; expanded professional guidelines may offer some protections against inequitable, discretionary care. [ABSTRACT FROM AUTHOR]
- Subjects :
- *POSTPARTUM depression diagnosis
*MATERNAL health services
*CONFIDENCE intervals
*HISPANIC Americans
*RACE
*RETROSPECTIVE studies
*ACQUISITION of data
*MEDICAL screening
*DRUG use testing
*MEDICAL protocols
*MEDICAL records
*HEALTH insurance
*DESCRIPTIVE statistics
*RESEARCH funding
*HEALTH equity
*ELECTRONIC health records
*MEDICAID
*URINALYSIS
*ODDS ratio
*AFRICAN Americans
Subjects
Details
- Language :
- English
- ISSN :
- 07307659
- Volume :
- 50
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Birth: Issues in Perinatal Care
- Publication Type :
- Academic Journal
- Accession number :
- 169828695
- Full Text :
- https://doi.org/10.1111/birt.12717