Date of Conferral

2019

Degree

Ph.D.

School

Public Health

Advisor

Nicoletta M. Alexander

Abstract

The prevalence of maternal morbidities continues to increase in U.S. women of lower socioeconomic status and non-Hispanic Black women despite the efforts of health care practitioners to reduce the disparities. Two decades of research has shown that physicians avoid patients based on insurance and socioeconomic status or their malpractice history. Reducing maternal illness and complications is one of the federal government's top 10 maternal health indicators in the Healthy People 2020 initiative. The purpose of this study was to evaluate the influence of malpractice allegations on patients at high-risk for maternal morbidity. Supported by the theoretical foundation of human factor theory, the focus of the research questions was on the relationship between obstetrics-related malpractice allegations and maternal and severe maternal morbidities in Black/African American women or women who have Medicaid or Medicare. The study involved a retrospective secondary analysis of data from the National Practitioner Data Bank, years 2006 and 2007 and the National Hospital Discharge Survey, years 2006-2008, from the Inter-University Consortium for Political and Social Research, as well as National Plan and Provider data from the Centers for Medicare and Medicaid Services. A logistic regression analysis indicated an association between bed size and days of care with maternal morbidities and severe maternal morbidities; however, no association with malpractice allegations was found. This study contributes to social change by raising awareness of continued morbidity disparities in women of lower social economic status and non-Hispanic Black women and contributes to the current literature.

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