OBJECTIVES

Evaluate patterns of utilization and associated costs of emergency transport among women with a diagnosis of pre-term labor to assess potential interventions and improve delivery of care.

METHODS

The IBM Treatment Pathways® tool was used to interrogate a 10 million patient cohort randomly selected from the MarketScan® dataset. This cohort includes detailed administrative medical claims data from 1/1/2012 to 1/31/2019. ICD-9 and -10 codes were used to identify patients diagnosed with pre-term labor; CPT codes for emergency air and ground transport were used to determine transport patterns and cost. The analysis was conducted on a cohort of women ages 16-45. Differences in costs and utilization patterns were assessed by the type of emergency transport service and geography (rural or non-rural).

RESULTS

A cohort of 2,438,994 women between the ages of 16 and 45 were included in the analysis. Of these 13,650 received a diagnosis of pre-term labor during the 7-year study period. Fifteen percent (n=2,030) had evidence of emergency transport within a day of the pre-term labor diagnosis. The median cost of any emergency transport in this group was $28,618; ground transport = $27,015; air-evac service = $53,758. The median cost of emergency transport did not differ significantly between rural and urban areas. The analysis by geography revealed that 23% (n= 376) of patients living in rural areas required emergency transport compared to 14% (n=1,616) of those in non-rural areas. Additionally, women in rural areas were 2x more likely to receive transport via air.

CONCLUSIONS

The prevalence of emergency transport for preterm labor in rural areas is significant compared to non-rural areas. While the costs of emergency transport by is similar between geographic locations, the disproportionate use of air transport in rural areas increases the associated costs of a preterm labor event for women located in rural areas.