A Resource and Cost Analysis on the Impact of Reduced Visits for Prenatal Care [29F

Abstract

INTRODUCTION: Prenatal care is resource intensive, marked by frequent provider visits. Several studies have demonstrated reduced prenatal visits show no difference of outcomes in low risk pregnancies, yet are subject to decreased patient satisfaction. Our objective was to perform a resource analysis of reduced visits supplemented by the use of digital tools during prenatal care for improved satisfaction. METHODS: As accurate data on resource consumption during prenatal care is lacking, we first gathered these data from interviews of over 100 clinicians representing a variety of practice settings (private practices, academic centers & large systems). We then studied an alternative prenatal schedule with reduced visits supplemented with mobile technology and home monitoring. Finally, we extrapolated the impact of visit reduction from an individual pregnancy to a large system. RESULTS: On average, outpatient prenatal care was $1,164.66. With a modified visit schedule, the cost for a low risk pregnancy is reduced to $665.52, leading to a cost savings of $499.14 per pregnancy. Similarly, an analysis of clinic time per pregnancy showed that effective care was delivered with an average of 6 fewer visits (or 90 minutes clinical time) with the modified schedule. When extrapolated to a typical practice with 1000 deliveries/year, this translated to $499,140 in cost savings and 6000 fewer visits (or 1,500 hours). CONCLUSION: While further studies are required to validate the benefits for using mobile/digital tools, the initial analysis indicates that it could lead to significant cost savings or additional revenue while still delivering high quality care.