Grants and Contracts Details
Description
Abstract
Kentucky consistently ranks in the highest percentiles (2nd-6th) of US states for high maternal
mortality rates (2016-2021).1-2 Substance use (51%) and mental health conditions (54%) were
contributing factors in the high maternal mortality rates.
Maternal deaths and injuries may be categorized as pregnancy-related or pregnancy-associated. The
former includes death or injury directly caused or linked to the physiologic effects of being pregnant or
postpartum.1-2 While pregnancy-associated includes maternal homicides, suicides, accidental deaths and
injuries from other external causes.6-9 Because these are considered pregnancy-associated, the deaths
are not included in national maternal mortality statistics.1-2
Over the past 3 years, Kentucky’s Annual Maternal Mortality Review Board has estimated that 78-
91% of maternal deaths were linked to 1) partner or family violence, 2) substance use, or 3) mental
health challenges. Most importantly, all three factors are preventable because they can be identified
during prenatal care.3-5 As such, evaluating healthcare utilization and related costs for these preventable
factors represents estimated savings to the Medicaid system and provides a pathway for supporting
efforts to reduce maternal death and injury.
This cost evaluation leverages a UK-KDPH partnership to calculate Medicaid costs arising from
pregnancies where violence, substance use, or mental health issues are diagnosed (defined by ICD-10
diagnosis codes, in use by 2016). Using a cohort of Medicaid claims identified as pregnant or
postpartum, Medicaid cost comparisons will be made for those who have ICD-10 codes corresponding to
violence, substance use, or mental health issues to those without these codes. This comparison will
provide an estimate of the relative cost of the three most commonly experienced causes of maternal
deaths or injuries: violence, substance use, and mental health concerns.3-5 Understanding the
differences in costs, healthcare utilization, and morbidity among pregnant or postpartum Kentuckians
covered by Medicaid will provide the impetus for prioritizing effective intervention and prevention
strategies targeting pregnancy-associated causes of maternal morbidity and mortality.
Status | Active |
---|---|
Effective start/end date | 12/1/24 → 6/30/26 |
Funding
- KY Cabinet for Health and Family Services: $31,146.00
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