Association of Medicaid Accountable Care Organizations and postpartum mental health care utilization.

Objective: To examine the association of Massachusetts Medicaid Accountable Care Organization (ACO) implementation with changes in mental health care utilization in the postpartum period.

Study Setting And Design: We examine care for people with a birth covered by Medicaid or private insurance. We used a difference-in-differences design to compare differences before and after Medicaid ACO implementation for those with Medicaid versus those with private insurance.

Transitions in health insurance among continuously insured patients with schizophrenia.

Changes in health insurance coverage may disrupt access to and continuity of care, even for those who remain insured. Continuity of care is especially important in schizophrenia, which requires ongoing medical and pharmaceutical treatment. However, little is known about continuity of insurance coverage among those with schizophrenia.

Continuity of Clinician Type and Intrapartum Experiences During the Perinatal Period in California.

Introduction: Continuity of care with an individual clinician is associated with increased satisfaction and better outcomes. Continuity of clinician type (ie, obstetrician-gynecologist or midwife) may also impact care experiences; however, it is unknown how common it is to experience discontinuity of clinician type and what its implications are for the birth experience. We aimed to identify characteristics associated with having a different clinician type for prenatal care than for birth and to compare intrapartum experiences by continuity of clinician type.

Person-Centered Maternity Care and Health Outcomes at 1 and 6 Months Postpartum.

Person-centered care has been increasingly recognized as an important aspect of health care quality, including in maternity care. Little is known about correlates and outcomes of person-centered care in maternity care in the United States. Data were from a prospective cohort of more than 3000 individuals who gave birth to a first baby in a Pennsylvania hospital.

Enhancing Clinical Teaching in Critical Thinking, High-Value Care, and Health Care Equity.

Introduction: Faculty development in the clinical setting is challenging to implement and assess. This study evaluated an intervention (IG) to enhance bedside teaching in three content areas: critical thinking (CT), high-value care (HVC), and health care equity (HCE).

Methods: The Communities of Practice model and Theoretical Domains Framework informed IG development.

Optimizing allocation of curricular content across the Undergraduate & Graduate Medical Education Continuum.

Background: Medical educators struggle to incorporate socio-cultural topics into crowded curricula. The "continuum of learning" includes undergraduate and graduate medical education. Utilizing an exemplar socio-cultural topic, we studied the feasibility of achieving expert consensus among two groups of faculty (experts in medical education and experts in social determinants of health) on which aspects of the topic could be taught during undergraduate versus graduate medical education.

Postpartum Visit Attendance in the United States: A Systematic Review.

Introduction: Adequate postpartum care, including the comprehensive postpartum visit, is critical for long-term maternal health and the reduction of maternal mortality, particularly for people who may lose insurance coverage postpartum. However, variation in previous estimates of postpartum visit attendance in the United States makes it difficult to assess rates of attendance and associated characteristics.

Methods: We conducted a systematic review of estimates of postpartum visit attendance.

Recovery from Obstetric Anal Sphincter Injury in a Prospective Cohort of First Births.

Objective: To identify risk factors for obstetric anal sphincter injuries (OASIS) for primiparous women who gave birth vaginally and to compare recovery by OASIS status in three domains as follows: (1) physical health and functioning, (2) mental health, and (3) healthcare utilization.

Study Design: This secondary analysis used data from 2,013 vaginal births in the First Baby Study, a prospective cohort study of women with first births between 2009 and 2011. Interview data at multiple time points were linked to birth certificate and hospital discharge data.

Perceived discrimination during the childbirth hospitalization and postpartum visit attendance and content: Evidence from the Listening to Mothers in California survey.

Objective: Postpartum visits are an important opportunity to address ongoing maternal health. Experiences of discrimination in healthcare can impact healthcare use, including postpartum visits. However, it is unknown whether discrimination is associated with postpartum visit content.

Receiving Real-Time Clinical Feedback: A Workshop and OSTE Assessment for Medical Students.

Background: Many programs designed to improve feedback to students focus on faculty's ability to provide a safe learning environment, and specific, actionable suggestions for improvement. Little attention has been paid to improving students' attitudes and skills in accepting and responding to feedback effectively. Effective "real-time" feedback in the clinical setting is dependent on both the skill of the teacher and the learner's ability to receive the feedback.

Association of Insurance Status With Provision of Recommended Services During Comprehensive Postpartum Visits.

Importance: Improving care during the postpartum period is a clinical and policy priority. During the comprehensive postpartum visit, guidelines recommend delivery of a large number of assessment, screening, and counseling services. However, little is known about services provided during these visits.

The Scope of Midwifery Practice Regulations and the Availability of the Certified Nurse-Midwifery and Certified Midwifery Workforce, 2012-2016.

Introduction: Studies have linked midwifery practice laws to the availability of midwives but have generally not related workforce data to potential demand for reproductive health services. We examined state regulatory structure for midwives and its relationship to midwifery distribution and vital statistics data at the state and county level.

Methods: Midwifery distribution data came from the Area Health Resources Files, distribution of women of reproductive age came from the US Census, and birth statistics came from US Natality Files from 2012 to 2016.