Exhibit 4.
Average Adjusted Hospitalization Costs, Hospital Length of Stay, and Severe Maternal Morbidity, by Mental Health Status Designations and Payer
| Mental Health Grouping | Percent of Deliveries | Cost Per Stay ($) | Length of Stay (Days) | Severe Maternal Morbidity per 10,000 Deliveries |
|---|---|---|---|---|
|
| ||||
| % | Mean | Mean | Rate | |
|
| ||||
| Privately-Covered Deliveries (n=739,381; weighted n=3,696,901) | ||||
| Any Mental Health Disorder | ||||
| No | 94.6 | 5064 | 2.7 | 109.6 |
| Yes | 5.5 | 5462 | 2.8 | 163.3 |
|
| ||||
| Number of Mental Health Disorders | ||||
| 0 | 94.6 | 5064 | 2.7 | 109.6 |
| 1 | 4.1 | 5453 | 2.8 | 161.1 |
| ≥2 | 1.3 | 5489 | 2.8 | 170.1 |
|
| ||||
| Anxiety Disorder | ||||
| No | 96.4 | 5071 | 2.7 | 110.7 |
| Yes | 3.6 | 5472 | 2.8 | 161.4 |
|
| ||||
| Depressive Disorder | ||||
| No | 97.4 | 5076 | 2.7 | 111.1 |
| Yes | 2.6 | 5423 | 2.8 | 164.8 |
|
| ||||
| Bipolar Disorder | ||||
| No | 99.7 | 5084 | 2.7 | 112.3 |
| Yes | 0.3 | 5479 | 2.8 | 179.0 |
|
| ||||
| Trauma-Related Disorder | ||||
| No | 99.8 | 5083 | 2.7 | 112.3 |
| Yes | 0.2 | 5972 | 2.9 | 204.0 |
|
Medicaid-Covered Deliveries (n=633,091; weighted n=3,165,452) | ||||
| Any Mental Health Disorder | ||||
| No | 93.7 | 4998 | 2.6 | 164.2 |
| Yes | 6.3 | 5471 | 2.8 | 239.7 |
|
| ||||
| Number of Mental Health Disorders | ||||
| 0 | 93.7 | 4998 | 2.6 | 164.2 |
| 1 | 4.5 | 5423 | 2.8 | 234.2 |
| ≥2 | 1.8 | 5586 | 2.9 | 253.3 |
|
| ||||
| Anxiety Disorder | ||||
| No | 96.7 | 5013 | 2.6 | 166.7 |
| Yes | 3.3 | 5487 | 2.8 | 233.6 |
|
| ||||
| Depressive Disorder | ||||
| No | 96.8 | 5014 | 2.6 | 166.6 |
| Yes | 3.2 | 5469 | 2.8 | 241.1 |
|
| ||||
| Bipolar Disorder | ||||
| No | 98.9 | 5023 | 2.6 | 168.0 |
| Yes | 1.1 | 5484 | 2.9 | 258.0 |
|
| ||||
| Trauma/Stress-Related Disorder | ||||
| No | 99.5 | 5024 | 2.6 | 168.4 |
| Yes | 0.5 | 5808 | 2.9 | 275.4 |
SOURCE:
Authors’ analysis of data from the Healthcare Cost and Utilization Project, National Inpatient Sample, years 2016 and 2017.
NOTES:
Adjusted costs and lengths of stay determined using generalized linear models with gamma distribution and log link. Adjusted rates of severe maternal mortality per 10,000 deliveries determined using predicted probabilities based on logistic regressions. All models were adjusted for age, race, number of other (i.e., non-mental health or substance use-related) clinical comorbidities, presence of a substance use disorder, having a cesarean vs vaginal delivery, median income in the patient’s zip code of residence, hospital census region, hospital ownership, hospital teach status and rural/urban designation, safety net hospital designation, and minority hospital designation. Regressions for privately- and Medicaid-covered deliveries were conducted separately. Regressions were not completed for Medicare-covered deliveries, given the small sample size of this population. All differences in means are statistically significant (p<0.001) using Wald tests to test for differences between average adjusted hospitalization costs between categories of each mental health grouping.