Mobile Integrated Health for Postpartum Blood Pressure Monitoring: Impact on Hospital Readmissions [A237

Abstract

INTRODUCTION: Starting in December 2019, Grady Memorial Hospital, a public institution in Atlanta, Georgia, implemented a home visiting mobile integrated health (MIH) program to reduce risk for postpartum complications among women with hypertensive disorders of pregnancy (HDP). We aimed to assess the impact of the MIH intervention on readmission rates. METHODS: Using electronic medical record for all deliveries between March 2018 and June 2021 at Grady Memorial Hospital, we calculated monthly rates of all-cause readmissions within 42 days of delivery discharge. We used a controlled interrupted time series design to compare readmission rates before (March 1, 2018, to November 30, 2019) and after (December 1, 2019, to June 30, 2021) the implementation of the MIH program for deliveries with and without HDP, assuming a level and slope change. Deliveries without HDP were not eligible for the MIH intervention and were used as controls. Emory’s institutional review board approved this study. RESULTS: There were 3,455 deliveries with HDP and 4,479 deliveries without HDP. Overall rates of readmission for deliveries with and without HDP were 3.7% (95% CI, 2.9–4.7%) and 1.8% (95% CI, 1.3–2.4%) in the pre-MIH period and 3.9% (95% CI, 3.0–5.1%) and 1.9% (95% CI, 1.4–2.6%) in the post-MIH period, respectively. We found no evidence of a sudden change in readmission rates (β, 0.029; P=.96) or a linear trend in readmissions (β, –0.069; P=.17) following the implementation of the MIH intervention among deliveries with HDP compared with deliveries without HDP. CONCLUSION: A MIH intervention for women with HDP was not associated with decreased rates of postpartum readmissions in our population.