Volume 53 | Number S3 | December 2018

Abstract List

Jonathan G. Shaw M.D., M.S., Vilija R. Joyce M.S., Susan K. Schmitt Ph.D., Susan M. Frayne M.D., M.P.H., Kate A. Shaw M.D., M.S., Beate Danielsen Ph.D., Rachel Kimerling Ph.D., Steven M. Asch M.D., M.P.H., Ciaran S. Phibbs Ph.D.


To describe variation in payer and outcomes in Veterans’ births.


Secondary data analyses of deliveries in California, 2000–2012.

Study Design

We performed a retrospective, population‐based study of all live births to Veterans (confirmed via U.S. Department of Veterans Affairs () enrollment records), to identify payer and variations in outcomes among: (1) Veterans using coverage and (2) Veteran vs. all other births. We calculated odds ratios () adjusted for age, race, ethnicity, education, and obstetric demographics.


We anonymously linked administrative data for all female enrollees with California birth records.

Principal Findings

From 2000 to 2012, we identified 17,495 births to Veterans. covered 8.6 percent (1,508), Medicaid 17.3 percent, and Private insurance 47.6 percent. Veterans who relied on health coverage had more preeclampsia ( 1.4, 1.0–1.8) and more cesarean births ( 1.2, 1.0–1.3), and, despite similar prematurity, trended toward more neonatal intensive care () admissions ( 1.2, 1.0–1.4) compared to Veterans using other (non‐Medicaid) coverage. Overall, Veterans’ birth outcomes (all‐payer) mirrored California's birth outcomes, with the exception of excess care ( 1.15, 1.1–1.2).


covers a higher risk fraction of Veterans’ births, justifying maternal care coordination and attention to the maternal–fetal impacts of Veterans’ comorbidities.