Table 3.
Association Between Insurance Status and Health Care Use, Women Living in Mecklenburg County Who Gave Birth Within Atrium Health (2014–2015)*
| Well-woman visits |
ED visits |
No first trimester prenatal care |
Adequate prenatal care |
6-week postpartum follow-up |
|
|---|---|---|---|---|---|
| RR (95% CI) | RR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Insurance | |||||
| Commercial | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Medicaid | 0.25 (0.23–0.28) | 2.93 (2.64–3.25) | 1.18 (1.03–1.34) | 1.35 (1.20–1.51) | 0.65 (0.58–0.74) |
| Uninsured | 0.23 (0.15–0.35) | 2.31 (1.68–3.17) | 1.84 (1.45–2.35) | 0.48 (0.39–0.60) | 0.42 (0.34–0.51) |
| Age at delivery | |||||
| 18–24 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| 25–34 | 1.61 (1.42–1.81) | 0.67 (0.60–0.74) | 0.89 (0.84–0.95) | 1.07 (1.01–1.13) | 1.10 (1.03–1.18) |
| 35+ | 1.88 (1.65–2.13) | 0.51 (0.45–0.59) | 0.94 (0.87–1.01) | 0.95 (0.88–1.03) | 1.04 (0.95–1.13) |
| Race/ethnicity | |||||
| Hispanic | 0.54 (0.47–0.61) | 0.79 (0.70–0.90) | 1.03 (0.94–1.12) | 0.77 (0.71–0.83) | 0.70 (0.64–0.76) |
| Non-Hispanic Black | 0.99 (0.91–1.08) | 2.08 (1.83–2.36) | 1.03 (0.96–1.12) | 1.07 (0.99–1.16) | 0.95 (0.87–1.04) |
| Non-Hispanic White | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Other | 0.64 (0.58–0.71) | 0.72 (0.62–0.84) | 1.42 (1.30–1.56) | 0.89 (0.82–0.98) | 1.05 (0.95–1.17) |
| Location of residence | |||||
| Charlotte | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Other Mecklenburg County | 1.05 (0.96–1.15) | 0.82 (0.69–0.97) | 1.00 (0.92–1.08) | 1.03 (0.95–1.12) | 1.05 (0.95–1.17) |
| Medical comorbidity | |||||
| Hypertension | 1.14 (0.94–1.38) | 1.85 (1.48–2.32) | 0.83 (0.73–0.94) | 1.21 (1.06–1.39) | 1.10 (0.95–1.27) |
| Diabetes | 1.19 (0.89–1.57) | 2.16 (1.54–3.02) | 0.90 (0.74–1.09) | 0.69 (0.57–0.83) | 0.90 (0.73–1.11) |
| Body mass index (BMI) | |||||
| Underweight (<18.5) | 0.96 (0.74–1.26) | 1.05 (0.68–1.62) | 1.04 (0.74–1.47) | 1.14 (0.79–1.64) | 1.32 (0.84–2.08) |
| Normal (18.5–24.9) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Overweight (25.0–29.9) | 0.85 (0.78–0.92) | 1.14 (1.02–1.26) | 1.05 (0.94–1.18) | 0.93 (0.83–1.05) | 0.97 (0.84–1.11) |
| Obese (30–39.9) | 0.89 (0.81–0.97) | 1.23 (1.11–1.38) | 1.16 (1.03–1.31) | 0.82 (0.72–0.92) | 0.95 (0.83–1.10) |
| Severe obesity (≥40) | 0.92 (0.80–1.05) | 1.18 (0.99–1.40) | 0.86 (0.73–1.01) | 1.07 (0.91–1.26) | 0.81 (0.67–0.97) |
| Neighborhood poverty rate | 0.99 (0.99–1.00) | 1.01 (1.00–1.01) | 1.00 (0.99–1.01) | 1.00 (0.99–1.00) | 0.99 (0.99–1.00) |
| Neighborhood percent with less than high school education | 1.00 (0.99–1.00) | 1.00 (1.00–1.01) | 1.00 (1.00–1.01) | 1.00 (0.99–1.01) | 0.99 (0.99–1.00) |
*
Results from negative binomial or logistic regression models.
CI, confidence interval; RR, rate ratio; OR, odds ratio.