Racial Disparities, Fragmentation of Care, and Adverse Outcomes Associated with Ectopic Pregnancy

Ectopic pregnancy (EP) is a rare condition that occurs in 1% of all pregnancies. However, women of lower socioeconomic status (SES) and ethnic minority groups are at greater risk of adverse outcomes associated with EP than White women. The purpose of this study was to examine data from the 2014 National Inpatient Sample to identify predictors of complications from EP in 2,626 females ages 15-44 in the United States. The theoretical framework used to guide this study was the theory of fundamental causes to explain why the association between SES and mortality has persisted despite progressive advances in the diseases and risk factors that are believed to explain it. Independent t-tests were conducted to determine whether significant differences in patient outcomes existed between EP participants who required one medical intervention during hospitalization and those with two or more medical interventions. Multiple linear regression analyses were used to examine the association between race, primary expected payer, income, number of procedure codes on record, number of diagnoses on record, and length of stay. The key findings were that for every increase in number of procedures (β = 0.13, p \u3c.001) the length of stay also increased by 0.13 units; for every increase in number of diagnoses (β = 0.37, p \u3c.001) length of stay increased by .37 units, and within the Black racial/ethnicity (β = 0.05, p \u3c .05) length of stay increased by 0.05 units. Finally, for females within a higher income quartile of $45,000 or more (β = .08, p \u3c .001), length of stay decreased by -0.08 units. Positive social change implications may include assistance to public health professionals in identifying individual factors that place women at increased risk for EP and the ability to increase EP prevention activity in populations that may be more susceptible to the condition and complications