Remote postpartum healthcare appointments effective in mitigating racial disparity.

by | Feb 12, 2023 | Telehealth News

In a recent study, it has been found that telehealth postpartum appointments improve the rate of attendance in black individuals, compared to that of solely in person appointments. The study, which was written up in the February issue of the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine, sought to determine how the use of telehealth during the COVID-19 pandemic might affect levels of racial disparities in this form of healthcare delivery. The United States has a extremely low records for maternal care among other high-income nations. This is illustrated through the maternal death rate in the country, which was over three times higher than that of many high-income nations in 2020. Additionally, there are severe racial differences in maternal care outcomes in the US, with Black women having a greater than 2.5-fold higher risk of passing away during a period of pregnancy or childbirth than Caucasian women. The study also found that over fifty percent of pregnancy-related deaths occur following the delivery of the women’s child. Researchers from Penn Medicine carried out a retrospective cohort analysis at a single tertiary care facility to examine if telemedicine could help bridge race-based inequalities in postpartum visit attendance. Data from a three-month period in 2020, following the adoption of telehealth options for postpartum care, was compared to data from the same period in the previous year prior to the implementation of telehealth options. In the study, if a patient scheduled a postpartum appointment between twenty-one and fifty six days after giving birth, they were considered eligible within the analysis. Among the 1,579 patients who met the inclusion criteria, 780 had a postpartum visit scheduled before the deployment of telemedicine services and 799 individuals one scheduled an appointment after. 317 patients had audio-only visits, 174 had video visits, and 156 had in-person visits in the post-implementation group. Moreover, 63 percent of patients identified as Black, twenty six percent as White, and only one percent as Latina.

 Prior to the installation of telemedicine, researchers discovered that Black patients were less likely than non-Black patients to attend a postpartum appointment, with Black patients attending these visits at a rate of just 63.9 percent compared to approximately eighty nine percent of their non-Black peers. Following the implementation of telehealth, Black patients still had lower postpartum visit attendance rates than non-Black patients. In contrast to this the following variables were considered and were found to have no discernible difference by racial factors:

  •  Insurance
  •  Education
  •  Parity
  •  Scant prenatal care

The study also reveals that, prior to the installation of telemedicine, Black patients were far less likely than non-Black patients to get a postpartum depression test, breastfeed their children, or  opt to attend follow-up cardiology appointments. Following the implementation of telehealth, there was no distinction between the two groups in terms of undergoing a postpartum depression test or going to a follow-up appointment with a cardiologist.  In addition to this non-Black patients were also more likely than Black patients to breastfeed.

Researchers of the study acknowledged the likelihood of the pandemic affecting their findings, stating the following: “Our analysis cannot account for the overall impact of the COVID-19 pandemic, which led to the rapid implementation and deimplementation of evolving practices for our postimplementation group”. This was continued where researchers emphasized that their findings ‘may not be generalizable to current practice.’

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