Accuracy of the drug dependency checkbox on the Maine birth certificate for Medicaid-covered births, 2016-2020

J. Dudley, C. McGuire, A. Kumarage, C. Anumaka, K. Ahrens
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Abstract

Introduction: The accuracy of the drug dependency checkbox on the Maine birth certificate is unknown. Our objective was to compare the drug dependency checkbox with information on substance use disorders as documented in Medicaid claims data. Methods: Using rule-based deterministic matching, we linked Medicaid enrollment information to 2016-2020 Maine birth record data (N=58,584). Among the linked records (n=27,448), we identified maternal substance use disorder (SUD) diagnoses during the 280 days before through 7 days after delivery using ICD-CM-10 diagnosis codes. We used the following hierarchy to create mutually exclusive SUD categories: opioid use disorder (OUD), cannabis use disorder without cocaine use disorder, and other SUD disorders (alcohol, cocaine, nicotine, or other substance use diagnosis). Results: Among women enrolled in Medicaid at the time of delivery, 12% had drug dependency indicated on their birth record and 33% had at least one SUD diagnosis recorded in their Medicaid claims during pregnancy. Among the birth records with the drug dependency checkbox checked, 56% had an OUD, 25% cannabis use disorder without cocaine use disorder, 8% other SUD, and 10% had no SUD. Among those with the drug dependency checkbox unchecked, the corresponding percentages were 4%, 9%, 13%, and 75%. Discussion: Although diagnoses of OUD and cannabis use disorder were more common among birth records with the drug dependency checkbox checked, reporting of drug dependency on the birth record does not appear to accurately indicate SUD during pregnancy. Conclusions: Our findings suggest the drug dependency checkbox on the Maine birth certificate may be of limited value in identifying SUD during pregnancy.
2016-2020年缅因州医疗补助出生出生证明上药物依赖复选框的准确性
缅因州出生证明上的药物依赖复选框的准确性尚不清楚。我们的目的是比较药物依赖复选框与医疗补助索赔数据中记录的物质使用障碍信息。方法:使用基于规则的确定性匹配,我们将医疗补助登记信息与2016-2020年缅因州出生记录数据(N=58,584)联系起来。在相关记录(n=27,448)中,我们使用ICD-CM-10诊断代码确定了分娩前280天至分娩后7天的产妇物质使用障碍(SUD)诊断。我们使用以下层次来创建互斥的SUD类别:阿片类药物使用障碍(OUD)、大麻使用障碍(无可卡因使用障碍)和其他SUD障碍(酒精、可卡因、尼古丁或其他物质使用诊断)。结果:在分娩时参加医疗补助计划的妇女中,12%的人在出生记录上有药物依赖,33%的人在怀孕期间的医疗补助申请中至少有一次SUD诊断记录。在有药物依赖复选框的出生记录中,56%的人有OUD, 25%的人有大麻使用障碍但没有可卡因使用障碍,8%的人有其他SUD, 10%的人没有SUD。未勾选“药物依赖”的比例分别为4%、9%、13%和75%。讨论:虽然在药物依赖复选框被选中的出生记录中,OUD和大麻使用障碍的诊断更为常见,但在出生记录中报告药物依赖似乎并不能准确地指示怀孕期间的SUD。结论:我们的研究结果表明,缅因州出生证明上的药物依赖复选框可能在孕期识别SUD方面价值有限。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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