An Intervention Designed To Increase Post-Partum Visit Attendance Rates At A Federally Qualified Health Center
INTRODUCTION: Kalamazoo County has a high infant mortality rate, 6.7 per 1000 live births from 2013-2017. The initial 6 weeks post-delivery can be crucial to evaluate medical complications, provide contraceptive counseling, screen for postpartum depression and evaluate other social concerns. This project was designed to improve post-partum visit attendance and neonatal mortality at a federally qualified health center in Kalamazoo County.
METHODS: All patients that were seen for prenatal care by the WMED Family Medicine Residents were enrolled into this study. Scheduling templates were developed in which newborn and maternal post-partum visits were scheduled together. We compared post-partum attendance rates from 01/01/2017-12/31/2017 to 08/07/2018 (Implementation of couplet scheduling) to current. Data was collected at three-month intervals. Improvements in postpartum visit attendance rates were analyzed using the Chi-square test of independence. We also examined which factors are significantly related to post-partum visit attendance including whether this was a woman's first pregnancy, age at delivery, race, ethnicity, primary language, gestational age at first prenatal care visit, number of prenatal care visits, gestational age at delivery and infant gender. To quantify the effect of each factor on attendance we used odds ratios and Bonferroni adjusted confidence intervals.
RESULTS/CONCLUSION: Prior to implementation of this study, attendance rates for postpartum visits were 48%. Following implementation there is a significant increase of post-partum visit attendance rates by 79%. Although, data at this time is limited to the first 6 months from implementation, we foresee a steady rise as we continue collecting data.