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 health
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
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.