Group Prenatal Care and Emergency Room Utilization

Abstract

Pregnancy-related complaints are a significant driver of emergency room (ER) utilization among women. Because of additional time for patient education and provider relationships, group prenatal care may reduce ER visits among pregnant women by helping them identify appropriate care settings, improving understanding of common pregnancy discomforts, and reducing risky health behaviors. We conducted a retrospective cohort study, utilizing Medicaid claims and birth certificate data from a statewide expansion of group care, to compare ER utilization between pregnant women participating in group prenatal care and individual prenatal care. Using propensity score matching methods, we found that group care was associated with a significant reduction in the likelihood of having any ER utilization (–5.9% among women receiving any group care and –6.0% among women attending at least five group care sessions). These findings suggest that group care may reduce ER utilization among pregnant women and encourage appropriate health care utilization during pregnancy.

Group prenatal care successes, challenges, and frameworks for scaling up: a case study in adopting health care innovations

“…Evidence for CenteringPregnancy and Expect With Me specifically suggests that, compared to traditional individual prenatal care, group prenatal care is associated with positive outcomes including decreased rates of preterm birth, increased birth weight in preterm infants, increased breastfeeding initiation and duration [ 12 – 15 ], greater use of postpartum family planning services [ 16 , 17 ], and fewer emergency room visits in the third trimester of pregnancy, for largely low risk pregnant individuals [ 18 ]. Group care patients have better prenatal knowledge, feel better prepared for labor and delivery, and both patients and providers are more satisfied with care [ 19 , 20 ].…”

Group vs Individual Prenatal Care and Gestational Diabetes Outcomes

“…Strategies to enhance psychosocial health have been shown to reduce anxiety, empower individuals, and result in better glycemic control among individuals with GD, but they are not aimed to reduce GD risk. Group prenatal care (GPNC) is an innovative model of medical care to improve clinical outcomes and health behaviors and to reduce racial disparities . CenteringPregnancy (Centering Healthcare Institute, Boston, Massachusetts) is the most widely implemented GPNC model and includes a curriculum specifically targeting elements of healthy lifestyle and behaviors (eg, nutrition, exercise, goal setting, and self-care) and psychosocial improvement (eg, stress management, empowerment, and peer and family support) .…”

“…Group prenatal care (GPNC) is an innovative model of medical care to improve clinical outcomes and health behaviors and to reduce racial disparities. [13][14][15][16][17][18] CenteringPregnancy (Centering Healthcare Institute, Boston, Massachusetts) is the most widely implemented GPNC model and includes a curriculum specifically targeting elements of healthy lifestyle and behaviors (eg, nutrition, exercise, goal setting, and self-care) and psychosocial improvement (eg, stress management, empowerment, and peer and family support). 19,20 Previous studies [21][22][23][24][25][26][27][28][29][30][31] have found that pregnant participants receiving GPNC had less excessive gestational weight gain and better attendance at postpartum visits compared with those receiving traditional individual prenatal care (IPNC).…”

Impact of Group vs. Individual Prenatal Care Provision on Women’s Knowledge of Pregnancy-Related Topics: An Open, Controlled, Semi-Randomized Community Trial

“…Numerous studies that examined the effect of group prenatal care showed significant decreases in preterm birth rates [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], low birth weight [ 17 , 19 , 20 , 21 , 25 , 26 ], likelihood of having any emergency room utilization [ 27 ] and lower rates of gestational diabetes, compared to traditional one-on-one care [ 28 ].…”