1. Association of the Mental Health Parity and Addiction Equity Act and the Affordable Care Act on severe maternal morbidity.
- Author
-
Hall, Stephanie V., Zivin, Kara, Dalton, Vanessa K., Bell, Sarah, Kolenic, Giselle E., and Admon, Lindsay K.
- Subjects
- *
MENTAL illness treatment , *SUBSTANCE abuse treatment , *INSURANCE law , *HEALTH policy , *CONFIDENCE intervals , *CROSS-sectional method , *DISEASES , *HEALTH care reform , *AFFECTIVE disorders , *HEALTH insurance , *TIME series analysis , *DESCRIPTIVE statistics , *ANXIETY disorders , *DELIVERY (Obstetrics) , *MENTAL health services ,PATIENT Protection & Affordable Care Act - Abstract
This study aimed to characterize the association between Mental Health Parity and the Affordable Care Act and rates of severe maternal morbidity among a population of commercially insured individuals, including individuals with and without perinatal mood and anxiety disorders. We conducted a serial, cross-sectional analysis of individuals with an inpatient delivery in Optum's Clinformatics® Data Mart Database from 2008 to 2021. We applied an interrupted time series model with autoregressive integrated moving average to evaluate changes in quarterly severe maternal morbidity rates. Adjusted severe maternal morbidity rates declined from 167.2 (95%CI: [152.6, 181.9]) per 10,000 deliveries in the first quarter of 2008 to 98.2 (95%CI: [83.5, 112.8]) per 10,000 deliveries in the last quarter of 2021. Severe maternal morbidity rates remained higher, but declined to a greater degree, among those with perinatal mood and anxiety disorders (435.6, 95%CI: [379.9, 491.3], to 165.0, 95%CI: [109.3, 220.8] per 10,000 deliveries) compared to those without (153.0, 95%CI: [140.7, 165.3] to 81.8, 95%CI: [69.6, 94.1] per 10,000 deliveries). The observed association suggests implementation of Mental Health Parity and Affordable Care Act may have played a role in lowering rates of severe maternal morbidity, particularly among individuals with perinatal mood and anxiety disorders. • Severe maternal morbidity declined following federal mental health policy changes. • Severe maternal morbidity was higher among those with mood and anxiety disorders. • Severe maternal morbidity declined most among those with mood and anxiety disorders. • The Mental Health Parity and Affordable Care Acts may have contributed to improved birth outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF