Journal of women's health
-
Journal of women's health · Mar 2007
The effect of race on provider decisions to test for illicit drug use in the peripartum setting.
Testing for illicit drugs may expose women who test positive to severe legal and social consequences. It is unknown whether racial disparities in drug testing practices underlie observed disparities in legal and social consequences of positive tests. ⋯ We identified racial differences in rates of testing for illicit drug use between black and nonblack women. We found equivalent positivity rates among tested black and nonblack women. The prevalence of drug use among untested women is unknown, however, so although tested women had equivalent rates of substance use detected, whether black and nonblack substance users are equally likely to be identified in the course of peripartum care remains uncertain.
-
Journal of women's health · Mar 2007
Comparative StudyHospitalizations of pregnant HIV-infected women in the United States in the era of highly active antiretroviral therapy (HAART).
Highly active antiretroviral therapy (HAART) has improved the outlook of HIV-infected patients, but it has several side effects, particularly when it is used during pregnancy. Prior to the advent of HAART, HIV-infected women were at increased risk for adverse pregnancy outcomes. This report describes hospital use among pregnant HIV-infected women in the United States in the HAART era and compares hospitalizations for select morbidities in pregnant HIV-infected vs. uninfected women. ⋯ In addition, HIV-infected pregnant women were more likely to be hospitalized for major puerperal sepsis, sexually transmitted infections, urinary tract infections, bacterial infections, liver disorders, and preterm labor/delivery than uninfected women, even after adjusting for sociodemographic factors and comorbid conditions. No significant differences were observed in the rates of preeclampsia and antepartum hemorrhage in the two groups. HIV-infected pregnant women in the United States in the era of HAART remain at higher risk for several morbidities and adverse obstetrical outcomes than uninfected women.
-
Journal of women's health · Mar 2007
Age and gender differences in Medicare expenditures at the end of life for colorectal cancer decedents.
We examined age and gender differences in Medicare expenditures for colorectal cancer decedents in the last year of life (LYOL) through a cross-sectional study of Medicare administrative and claims data. Participants were aged Medicare beneficiaries (68+ years) with colorectal cancer, who were covered by Parts A and B for 36 months before death (1996-1999, n = 6657). We estimated differences in mean Medicare utilization and expenditures in the LYOL overall and by type of service (inpatient, outpatient, physician, skilled nursing facility [SNF], home health, and hospice). ⋯ Most of the gender differences in average Medicare expenditures were explained by gender differences in age and the lower average expenditures on older decedents with colorectal cancer. Remaining gender differences varied across age cohorts and were largest among those aged 68-74. Higher expenditures for women on each of the social supportive services (SNF, home health, and hospice), even among those who used a particular type of service, may reflect a lack of informal supports for older women compared with men.