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Sudden Shift to Telehealth in COVID-19: A Retrospective Cohort Study of Disparities in Use of Telehealth for Prenatal Care in a Large Midwifery Service.
- Source :
-
Journal of midwifery & women's health [J Midwifery Womens Health] 2024 Jul-Aug; Vol. 69 (4), pp. 522-530. Date of Electronic Publication: 2023 Dec 18. - Publication Year :
- 2024
-
Abstract
- Introduction: The coronavirus disease 2019 (COVID-19) pandemic created disruption in health care delivery, including a sudden transition to telehealth use in mid-March 2020. The purpose of this study was to examine changes in the mode of prenatal care visits and predictors of telehealth use (provider-patient messaging, telephone visits, and video visits) during the COVID-19 pandemic among those receiving care in a large, academic nurse-midwifery service.<br />Methods: We conducted a retrospective cohort study of those enrolled for prenatal care in 2 nurse-midwifery clinics between 2019 and 2021 (n = 3172). Use outcomes included number and type of encounter: in-person and telehealth (primary outcome). Comparisons were made in frequency and types of encounters before and during COVID-19. A negative binomial regression was fit on the outcome of telehealth encounter count, with race/ethnicity, age, language, parity, hypertension, diabetes, and depression as predictors.<br />Results: When comparing pre-COVID-19 (before March 2020) with during COVID-19 (after March 2020), overall encounters increased from 15.9 to 19.5 mean number of encounters per person (P < .001). The increase was driven by telehealth encounters; there were no significant differences for in-person prenatal visit counts before and during the pandemic period. Direct patient-provider messaging was the most common type of telehealth encounter. Predictors of telehealth encounters included English as primary language and diagnoses of diabetes or depression.<br />Discussion: No differences in the frequency of in-person prenatal care visits suggests that telehealth encounters led to more contact with midwives and did not replace in-person encounters. Spanish-speaking patients were least likely to use telehealth-delivered prenatal care during the pandemic; a small, but significant, proportion of patients had no or few telehealth encounters, and a significant proportion had high use of telehealth. Integration of telehealth in future delivery of prenatal care should consider questions of equity, patient and provider satisfaction, access, redundancies, and provider workload.<br /> (© 2023 by the American College of Nurse‐Midwives.)
- Subjects :
- Humans
Female
Retrospective Studies
Pregnancy
Adult
Healthcare Disparities
SARS-CoV-2
Nurse Midwives statistics & numerical data
Cohort Studies
Young Adult
Telemedicine statistics & numerical data
COVID-19 epidemiology
Prenatal Care statistics & numerical data
Midwifery statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1542-2011
- Volume :
- 69
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of midwifery & women's health
- Publication Type :
- Academic Journal
- Accession number :
- 38111228
- Full Text :
- https://doi.org/10.1111/jmwh.13601