The 130th Annual Meeting of APHA

Abstract #46773

Mary Anne Armstrong, MA¹, Veronica M. Gonzales, BS¹, Leslie Lieberman, MSW², Blong Xiong, MPH¹, and Gabriel J. Escobar, MD¹. (1) Division of Research, Kaiser Permanente, 3505 Broadway, Oakland, CA 94611, (510) 450-2226, Maryanne.Armstrong@kp.org, (2) Patient Care Services, Kaiser Permanente, 1950 Franklin, Oakland, CA 94612

Substance abuse during pregnancy has a major impact on health care delivery systems. We evaluated the effect of Early Start (ES), an obstetric clinic-based perinatal substance abuse treatment program, on inpatient and outpatient utilization one year before vs. one year after pregnancy. From a cohort of 6,774 women in a managed care organization who delivered babies between 07/01/95 and 06/30/98 and completed screening questionnaires, we identified and compared 4 groups of women: (1) screened, assessed and treated by ES (SAT, N=149), (2) screened and assessed with no follow-up treatment (SA, N=145), (3) positive tox screens but no ES intervention (S, N=141), and (4) no evidence of substance abuse (Controls, N=174). Outpatient analyses included individual clinics, e.g., Emergency Department (ED) and Psychiatry, and all clinics combined. Inpatient analyses focused on number of hospital stays and days hospitalized. The majority of women in all 4 groups had the same or fewer visits in the year post-pregnancy compared to the pre-pregnancy year. However, all 3 substance-abusing groups did worse than the control group. For example, 73% of the SAT women, 77% of the SA women, and 69% of S women had the same or fewer ED visits post-pregnancy compared to 82% of the controls (S vs controls, p=0.008). In all utilization categories, women with ES Program contact (SAT and SA) had lower post-pregnancy utilization rates than the untreated substance abusers(S). These preliminary results suggest that ES contact has a beneficial effect on utilization of health services that includes decreased use of the ED.

Learning Objectives:

• At the conclusion of this presentation, the participant will be able to recognize the value of a perinatal substance abuse treatment program located in obstetric departments and assess its effect on utilization of health services.

Keywords: Prenatal Interventions, Utilization

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.