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Rural Remote Health. 2015 Jul-Sep;15(3):3335. Epub 2015 Aug 18.

Do rural and urban women experience differing rates of maternal rehospitalizations?

Author information

1
Eliminate Health Disparities, Division of Health Policy and Legislative Affairs, University of Texas Medical Branch, Galveston, TX, USA . weilee@utmb.edu.
2
Texas A&M Health Science Center, School of Public Health, College Station, TX, USA. phillipscd@sph.tamhsc.edu.
3
Texas A&M Health Science Center, School of Public Health, Department of Health Policy and Management, College Station, TX, USA. rohsfeldt@sph.tamhsc.edu.

Abstract

INTRODUCTION:

Conditions such as postpartum complications and mental disorders of new mothers contribute to a relatively large number of maternal rehospitalizations and even some deaths. Few studies have examined rural-urban differences in hospital readmissions, and none of them have addressed maternal readmissions. This research directly compares readmissions for patients who delivered in rural versus urban hospitals.

METHODS:

The data for this cross-sectional study were drawn from the 2011 California Healthcare Cost and Utilization Project. Readmission rates were reported to demonstrate rural-urban differences. Generalized estimating equation models were also used to estimate the likelihood of a new mother being readmitted over time.

RESULTS:

The 323 051 women who delivered with minor assistance and 158 851 women who delivered by cesarean section (C-section) were included in this study. Of those, seven maternal mortalities occurred after vaginal deliveries and 14 occurred after C-section procedures. Fewer than 1% (0.98% or 3171) women with normal deliveries were rehospitalized. The corresponding number for women delivering via C-section was 1.41% (2243). For both types of deliveries, women giving birth in a rural hospital were more likely to be readmitted.

CONCLUSIONS:

This is the first study examining rural-urban differences in maternal readmissions. The results indicate the importance of monitoring and potentially improving the quality of maternal care, especially when the delivery involves a C-section. More studies investigating rural health disparities in women's health are clearly necessary.

KEYWORDS:

Consumer perspectives; Determinants of Health; Health Service reform; Management/Administration; North America; Procedures; Public Health; Researcher; Women's Health

PMID:
26280454
[Indexed for MEDLINE]
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