Objectives. To assess the relationship between doula utilization and health outcomes of females enrolled in Medicaid-affiliated plans in the United States. Methods. In this retrospective, observational cohort study, we used Medicaid claims data from a national health insurer to compare health outcomes between females who used and who did not use a doula (2014-2023). We conducted propensity score matching using a 1:1 case‒control match, without replacement, and fit logistic regressions to analyze the relative risks for maternal health outcomes. Results. The study population included 722 matched pairs with and without a doula. Results indicate females with doulas had a 47% lower risk of cesarean delivery and a 29% lower risk of preterm birth, and were 46% more likely to attend a postpartum checkup (all differences P < .05). Conclusions. Doula care is associated with improved health outcomes among Medicaid enrollees. Public Health Implications. Doulas have garnered increasing interest from policymakers as a strategy to address increasing trends in maternal morbidity and persistent health disparities. This study provides evidence from Medicaid enrollees across the United States that doula care can improve maternal health. (Am J Public Health. 2024;114(11):1275-1285. https://doi.org/10.2105/AJPH.2024.307805).

中文翻译：

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导乐在改善 Medicaid 参保者的孕产妇健康和健康公平方面的作用，2014\u20122023 年。


目标。评估导乐利用率与参加美国 Medicaid 附属计划的女性健康结果之间的关系。方法。在这项回顾性观察性队列研究中，我们使用了来自一家国家健康保险公司的医疗补助索赔数据来比较使用和不使用导乐的女性之间的健康结果（2014-2023 年）。我们使用 1：1 病例\对照匹配进行倾向评分匹配，无替换，并拟合 logistic 回归，以分析孕产妇健康结局的相对风险。结果。研究人群包括 722 对有和没有导乐的匹配对。结果表明，使用导乐的女性剖宫产风险降低 47%，早产风险降低 29%，参加产后检查的可能性高 46%（所有差异 P < .05）。结论。导乐护理与改善 Medicaid 参保者的健康状况有关。公共卫生影响。导乐作为解决孕产妇发病率上升趋势和持续健康差异的战略，已经引起了政策制定者越来越大的兴趣。这项研究提供了来自美国各地 Medicaid 参保者的证据，证明导乐护理可以改善孕产妇健康。（美国公共卫生杂志，2024 年;114(11):1275-1285.https://doi.org/10.2105/AJPH.2024.307805）。