Association of the United States Affordable Care Act Dependent Coverage Provision with Labor Neuraxial Analgesia Use
Main finding · Labor neuraxial analgesia utilization rateResult — go to the resultAdjusted absolute increase 1.0% 95% CI 0.8–1.2Authors' conclusion
Implementation of the Dependent Coverage Provision was associated with a statistically significant increase in labor neuraxial analgesia use, but the small effect size is unlikely of clinical significance.
Study context
- Population
- Spontaneous vaginal deliveries in 28 US states, 2009–2013birth certificates analyzed
- Participants
- 4,515,667 deliveries
- Comparison
- 21 to 25 yr vs 27 to 31 yr
- Outcome
- Labor neuraxial analgesia utilization rate
Methodological detailsdifference-in-differences (exposed vs unexposed age groups, pre- vs postintervention), birth certificate data, 28 US states
- Difference-in-differences (exposed vs unexposed age groups, pre- vs postintervention)
- Birth certificate data, 28 US states
Main finding
As reported in the abstract
Adjusted absolute increase
1.0%
95% CI 0.8–1.2
By group
21 to 25 yr vs 27 to 31 yr
adjusted absolute increase 1.0% (95% CI 0.8–1.2)
Further findings
Labor neuraxial analgesia use by race and ethnicity (subgroup)
- Increase statistically significant for White and Hispanic women but not for Black and Other race and ethnicity women
Original publication
Association of the United States Affordable Care Act Dependent Coverage Provision with Labor Neuraxial Analgesia Use. Anesthesiology. Published 25 May 2023. doi:10.
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