UP - Costs of Maternal Violence, Substance Use & Mental Health C5538 FY25

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.
StatusActive
Effective start/end date12/1/246/30/26

Funding

  • KY Cabinet for Health and Family Services: $31,146.00

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