Association of Medicaid Expansion With Neuraxial Labor Analgesia Use in the United States: A Retrospective Cross-Sectional Analysis
Bibliographic record
Abstract
(Anesth Analg. 2022;134:505–514) Before 2010, 1 in 4 women and 1 in 8 pregnant women were uninsured. The United States’ Patient Protection and Affordable Care Act enacted in 2010 aimed to insure these uninsured individuals and families by increasing Medicaid coverage. The number of states observing this act, as it is optional, has increased from 26 in 2014 to 38 in 2021. While Medicaid expansion increased coverage for prenatal care and childhood, Medicaid’s effect on neuraxial labor analgesia use is unclear. Previous studies show lower pain scores, and higher patient satisfaction scores are linked with neuraxial analgesia for the 75% of women who receive it. Localized labor analgesia minimizes general anesthesia risks, including airway complications, postoperative pain, and neonatal resuscitation. This study analyzes the effects of Medicaid expansion on neuraxial labor analgesia use since its adoption.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".