TY - JOUR
T1 - Perinatal Care Measures Are Incomplete If They Do Not Assess The Birth Parent–Infant Dyad As A Whole
AU - Handley, Sara C.
AU - Formanowski, Brielle
AU - Passarella, Molly
AU - Kozhimannil, Katy B.
AU - Leonard, Stephanie A.
AU - Main, Elliott K.
AU - Phibbs, Ciaran S.
AU - Lorch, Scott A.
N1 - Publisher Copyright:
© 2023 Project HOPE— The People-to-People Health Foundation, Inc.
PY - 2023/9
Y1 - 2023/9
N2 - Measures of perinatal care quality and outcomes often focus on either the birth parent or the infant. We used linked vital statistics and hospital discharge data to describe a dyadic measure (including both the birth parent and the infant) for perinatal care during the birth hospitalization. In this five-state cohort of 2010–18 births, 21.6 percent of birth parent–infant dyads experienced at least one complication, and 9.6 percent experienced a severe complication. Severe infant complications were eight times more prevalent than severe birth parent complications. Among birth parents with a severe complication, the co-occurrence of a severe infant complication ranged from 2 percent to 51 percent, whereas among infants with a severe complication, the co-occurrence of a severe birth parent complication was rare, ranging from 0.04 percent to 5 percent. These data suggest that measures, clinical interventions, public reporting, and policies focused on either the birth parent or the infant are incomplete in their assessment of a healthy dyad. Thus, clinicians, administrators, and policy makers should evaluate dyadic measures, incentivize positive outcomes for both patients (parent and infant), and create policies that support the health of the dyad.
AB - Measures of perinatal care quality and outcomes often focus on either the birth parent or the infant. We used linked vital statistics and hospital discharge data to describe a dyadic measure (including both the birth parent and the infant) for perinatal care during the birth hospitalization. In this five-state cohort of 2010–18 births, 21.6 percent of birth parent–infant dyads experienced at least one complication, and 9.6 percent experienced a severe complication. Severe infant complications were eight times more prevalent than severe birth parent complications. Among birth parents with a severe complication, the co-occurrence of a severe infant complication ranged from 2 percent to 51 percent, whereas among infants with a severe complication, the co-occurrence of a severe birth parent complication was rare, ranging from 0.04 percent to 5 percent. These data suggest that measures, clinical interventions, public reporting, and policies focused on either the birth parent or the infant are incomplete in their assessment of a healthy dyad. Thus, clinicians, administrators, and policy makers should evaluate dyadic measures, incentivize positive outcomes for both patients (parent and infant), and create policies that support the health of the dyad.
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U2 - 10.1377/hlthaff.2023.00398
DO - 10.1377/hlthaff.2023.00398
M3 - Article
C2 - 37669487
AN - SCOPUS:85169761549
SN - 0278-2715
VL - 42
SP - 1266
EP - 1274
JO - Health Affairs
JF - Health Affairs
IS - 9
ER -