Gestational diabetes testing among pregnant medicaid recipients: implications for clinical care
Abstract Objective: To evaluate factors related to gestational diabetes mellitus (GDM) testing and diagnosis among pregnant Medicaid recipients. Design: Retrospective analysis of claims and administrative data. Participants: Women enrolled in Medicaid and giving birth during a 12-month period in the mid-1990s in Florida, Georgia, New Jersey, and Texas. Methods: Data from GDM-related Medicaid claims were identified using ICD-9-CM and Current Procedural Terminology codes. Results: Across states, 11% to 34% of women underwent GDM testing, and African American women were less likely to receive GDM testing or a diagnosis of GDM than white women. In all states, a longer duration of Medicaid enrollment during pregnancy was associated with increased likelihood of GDM testing and diagnosis. Conclusion: Pregnant Medicaid recipients in our study had low rates of GDM testing at a time when universal screening of pregnant women was recommended. African American women were less likely to be tested for or diagnosed with GDM than Hispanic or white women. Medicaid enrollment characteristics were associated with GDM testing and diagnosis. Improving GDM testing among pregnant Medicaid-covered women could help decrease adverse outcomes and reduce racial disparities.