Treatment Patterns for Early Pregnancy Failure in Michigan

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dc.contributor.author Dalton, Vanessa K. en_US
dc.contributor.author Harris, Lisa H. en_US
dc.contributor.author Clark, Sarah J. en_US
dc.contributor.author Cohn, Lisa en_US
dc.contributor.author Guire, Ken en_US
dc.contributor.author Fendrick, A. Mark en_US
dc.date.accessioned 2010-10-14T14:20:47Z
dc.date.available 2010-10-14T14:20:47Z
dc.date.issued 2009-06 en_US
dc.identifier.citation Dalton, Vanessa K.; Harris, Lisa H.; Clark, Sarah J.; Cohn, Lisa; Guire, Ken; Fendrick, A. Mark (2009/05/17). "Treatment Patterns for Early Pregnancy Failure in Michigan." Journal of Women's Health, 18(6): 787-793 <http://hdl.handle.net/2027.42/78155> en_US
dc.identifier.issn 1540-9996 en_US
dc.identifier.uri http://hdl.handle.net/2027.42/78155
dc.description.abstract 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. en_US
dc.format.extent 166725 bytes
dc.format.extent 3100 bytes
dc.format.mimetype application/pdf
dc.format.mimetype text/plain
dc.publisher Mary Ann Liebert, Inc. en_US
dc.title Treatment Patterns for Early Pregnancy Failure in Michigan en_US
dc.type Article en_US
dc.subject.hlbtoplevel Health Sciences en_US
dc.description.peerreviewed Peer Reviewed en_US
dc.identifier.pmid 19445643 en_US
dc.description.bitstreamurl http://deepblue.lib.umich.edu/bitstream/2027.42/78155/1/jwh.2008.1091.pdf
dc.identifier.doi 10.1089/jwh.2008.1091 en_US
dc.identifier.source Journal of Women's Health en_US
dc.owningcollname Interdisciplinary and Peer-Reviewed
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