Research Day

AN INTERVENTION DESIGNED TO INCREASE POST-PARTUM VISIT ATTENDANCE RATES AT A FEDERALLY QUALIFIED HEALTH CENTER

Document Type

Abstract

Date

2021

Abstract

Introduction: Kalamazoo County has a high infant mortality rate, 6.7 per 1000 live births from 2013-2017.Mothers and infants are at highest risk of complications within the first few days following a delivery. 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 postpartum visit attendance rates from 08/07/2018 (Implementation of couplet scheduling) to current. Data was collected at three-month intervals. Improvements in post partum 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. There is a significant increase of post-partum visit attendance rates from 49% to 72% following implementation of couplet scheduling.

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