298285
Great Expectations: Georgia's Southwest Public Health District Improving Prenatal Access and Outcomes
Over 450 patients from 16 counties initiated care with mid-level providers in Dougherty and Colquitt Counties. Dougherty County patients are predominantly African-American (85%) and Medicaid-eligible (95%). The mean gestational age at the first prenatal visit (NOB) is 11 weeks with 73% initiating prenatal care in the first trimester. In contrast, 98% of Colquitt County patients are Hispanic. All are uninsured. The mean gestational age at NOB is 14 weeks and 52% begin care in the first trimester. Patients are transferred to private practices at 36 weeks or earlier for high-risk conditions.
Data were analyzed for 214 births: Dougherty (136) and Colquitt (78). The preterm birth rates for Dougherty County and Colquitt County program patients are 8.8% and 9.0%, respectively. Preterm birth rates at both sites are less than half the District’s baseline rate for Non-Hispanic African-Americans (18.2%); 35% less than the District’s baseline rate for non-Hispanic Caucasians (13.7%); and are less than the District’s Hispanic baseline (12.1%). Based on the baseline data, 14 preterm births were averted because of our program, resulting in a savings of $520,128 in direct medical and $722,400 in total costs.
Public/private healthcare partnerships are needed to expand prenatal care access and reduce disparate birth outcomes in medically underserved communities.
Learning Areas:
Clinical medicine applied in public healthConduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Learning Objectives:
Describe the barriers to early entry into prenatal care for Southwest Georgia low-income African-American and Hispanic Women
Explain the geographic and racial/ethnic birth outcomes disparities in Southwest Georgia
Demonstrate the effectiveness of increasing early access to patient-centered care on birth outcomes for low-income African-American and Hispanic Women in South Georgia
Keyword(s): Birth Outcomes, Underserved Populations
Qualified on the content I am responsible for because: I am a board-certified obstetrician gynecologist and the public health director of the Southwest Health District. I have been intimately involved in every aspect of the District's prenatal health program from its inception.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.