Treatment Patterns for Early Pregnancy Failure in Michigan
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 M. | 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 | https://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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