Operational Effects of Implementing Hybrid Prenatal Care Models: A Retrospective Analysis [ID: 1374984

Abstract

INTRODUCTION: Telemedicine is promising for improving prenatal care access but may generate unscheduled prenatal care utilization including phone calls and portal messages. We describe differences in care utilization between pregnant people receiving in-person only versus hybrid (in-person and telemedicine) models of prenatal care. METHODS: In this IRB-exempt electronic health record-based study, we identified patients who received prenatal care and gave birth at our academic institution between March 1, 2021 and March 31, 2022. We classified patients into four groups based on medical and social risk factors: A) completely low risk; B) high social risk only; C) high medical risk only; and D) completely high risk. We compared visit number, portal messages, and phone calls between patients who received hybrid versus in-person only care. We report medians for all measures. RESULTS: Of the 4,992 included patients, 48% received hybrid care. Patients in all groups had one additional visit if they received hybrid versus in-person care (A: 9 versus 8; B: 8 versus 7; C: 9 versus 8; D: 9 versus 8). Patients receiving hybrid care used more portal messages than patients in the same group who received in-person care: A: 8 versus 6; B: 9 versus 5; C: 10 versus 9; D: 12 versus 8. There was no significant difference in phone call utilization between the in-person and hybrid patient groups. CONCLUSION: Patients who received hybrid prenatal care tended to utilize prenatal care including both planned and unplanned services more frequently than exclusively in-person patients.