Presentations

Abstract

Introduction:

Maternal mortality and morbidity rates in the United States are the highest of any developed nation in the world. During the postpartum period, there is a shift in the focus of care from the mother to the baby. It is during the period, from delivery to about a year postpartum that most mothers experience complications and unfortunately death. When considering race, ethnicity and socioeconomic background, black persons who give birth have the highest rates of postpartum mortality and morbidity. In the recent years, these statistics and health equity concerns have gathered national and worldwide attention resulting in an earnest push to find adequate solutions.

Methods:

This study examined local practice protocols and statistics surrounding postpartum visit attendance. A survey was created that investigated how the practice conducted scheduling of postpartum visits for different scenarios, such as premature delivery or high-risk delivery. We also sought statistical information on attendance rates, no-show rates, and payer mix/patient demographic. Each survey was administered orally over the phone with a practice representative.

Results:

We identified thirty-one separate practices in the cities and counties surrounding Sentara Norfolk General. Of these 31, six practices completed the survey, four practices declined participation in the survey and the other 21 practices neither declined nor completed the survey. Three of the six practices who completed the survey reported they completed postpartum visit scheduling either at the last prenatal visit or by calling the patient after delivery. The other half required the patient call and schedule their own appointment. The practices that reported higher attendance rates also reported adequate availability of statistical data regarding these appointments. These practices also had a higher commercial payer population. For the other practices who either did not know the data or reported low attendance rates, the patient population was generally majority Medicaid users.

Conclusions:

Moving forward the formation of better protocols surrounding scheduling and follow-up with patients, as well as increased availability of statistical data regarding postpartum visit attendance is a necessity.