Treatment patterns for early pregnancy failure in Michigan.
J Womens Health (Larchmt)
; 18(6): 787-93, 2009 Jun.
Article
em En
| MEDLINE
| ID: mdl-19445643
ABSTRACT
AIMS:
We describe current treatment patterns for early pregnancy failure (EPF) among women enrolled in two Michigan health plans.METHODS:
We conducted a retrospective review of EPF treatment among Michigan Medicaid enrollees between January 1, 2001, and December 31, 2004, and enrollees of a university-affiliated health plan between January 1, 2001, and December 31, 2005. Episodes were identified by the presence of a diagnostic code for EPF. Surgical treatment was distinguished from nonsurgical management using procedure codes. Facility charges, procedure, and place of service codes were used to determine whether a procedure was done in an office as opposed to an operating room. Cases without a claim for surgical uterine evacuation were examined for a misoprostol pharmacy claim and, if present, were classified as medical management. Cases without a procedure or pharmacy claim were classified as expectant management.RESULTS:
Respectively, we identified 21,311 and 1,493 episodes of EPF in the Medicaid and university-affiliated health plan databases, respectively. Women enrolled in Medicaid were more likely to be treated with surgery than were enrollees of the university-affiliated health plan (35.3 vs. 18.0%, respectively, p < 0.000). Among Medicaid enrollees, only 0.5% of surgical evacuations occurred in the office, but office procedures were common among enrollees of the university-affiliated health plan (30.5%, p < 0.000). The proportion of cases managed with misoprostol was <1% in both groups. Caucasian race and age were both associated with having a surgical uterine evacuation (p < 0.001).CONCLUSIONS:
EPF is primarily being treated with expectant management or surgical evacuation in an operating room and may not reflect evidence-based practices or patient preferences.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Aborto Espontâneo
/
Cobertura do Seguro
/
Aborto Terapêutico
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Womens Health (Larchmt)
Assunto da revista:
GINECOLOGIA
/
SAUDE DA MULHER
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Estados Unidos