Date on Master's Thesis/Doctoral Dissertation
Health Management and Systems Sciences
Public Health Sciences with a specialization in Health Management, PhD
Pregnancy; spinal cord injury; paralysis; length of stay; hospitalization charges
BACKGROUND: Spinal cord injury (SCI) results from damage to the spinal cord, leading to a temporary or permanent alteration in its normal function, usually causing a lifelong disability. SCI is one of the major causes of paralysis. Due to a sparsity of available research and to address the existing gaps, it is essential to evaluate the inpatient hospital use of pregnant women with SCI/paralysis. METHODS: This study operationalizes inpatient hospital use in three ways. We used the National (Nationwide) Inpatient Sample (NIS) from 2006 through 2019. The first analysis used a hurdle model for length of hospital stay and a linear regression for total hospitalization charges to assess non-delivery-related healthcare utilization for pregnant women with SCI/paralysis. The second analysis employed negative binomial regression for length of stay and ordinary least squares regression for total hospitalization charges to examine delivery-related healthcare utilization for pregnant women with SCI/paralysis. The third analysis used propensity-score kernel matching to determine the impact of SCI/paralysis on the healthcare utilization for inpatient encounters of pregnant women divided into groups - with and without SCI/paralysis. RESULTS: The average length of hospital stay for pregnant women with SCI/paralysis admitted for non-delivery and delivery-related reasons were 7.85 days (median: 4 days, IQR: 2 - 7 days) and 8.11 days (median: 4 days, IQR: 2 - 8 days), respectively. The average total hospitalization charges for pregnant women with SCI/paralysis admitted for non-delivery and delivery-related reasons were $85,676.47 (median: $29,181.31, IQR: $15,757.56 - $70,767.22, in 2019 dollars) and $79,027.84 (median: $30,043.4, IQR: $16,164.16 - $78,386.09, in 2019 dollars). The pregnant women with SCI/paralysis had, on average, a length of stay of about three days (SE: 0.22) longer and a total hospitalization charge of approximately $30,393.23 (SE: $24,84.01, in 2019 dollars) more than the pregnant women without SCI/paralysis. CONCLUSION: Pregnant women with SCI/paralysis have greater hospital inpatient service utilization when compared to those without SCI/paralysis. It is essential for a healthcare delivery system to understand the extent of healthcare utilization of pregnant women with SCI/paralysis to be able to develop effective programs and policies to address the needs of this population.
Salunkhe, Sonali S., "Inpatient department hospital utilization among pregnant women with spinal cord injury or paralysis in the United States." (2023). Electronic Theses and Dissertations. Paper 4100.
Retrieved from https://ir.library.louisville.edu/etd/4100