Telehealth Utilization in High-Risk Pregnancies During COVID-19
Purpose: To determine how telehealth has influenced outcomes in high-risk obstetrics patients during the Coronavirus disease 2019 (COVID-19) pandemic. Methods: A retrospective chart review was conducted to identify patterns in both telehealth and in-person clinic visits among patients of a Maternal...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Mary Ann Liebert
2023-05-01
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| Series: | Telemedicine Reports |
| Subjects: | |
| Online Access: | https://www.liebertpub.com/doi/full/10.1089/TMR.2023.0006 |
| _version_ | 1797345975326474240 |
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| author | Margie A. Rayford Joshua M. Morris Ramona Phinehas Elizabeth Schneider Amanda Lund Sarah Baxley Jim Y. Wan Patricia J. Goedecke Roberto Levi-D'Ancona |
| author_facet | Margie A. Rayford Joshua M. Morris Ramona Phinehas Elizabeth Schneider Amanda Lund Sarah Baxley Jim Y. Wan Patricia J. Goedecke Roberto Levi-D'Ancona |
| author_sort | Margie A. Rayford |
| collection | DOAJ |
| description | Purpose: To determine how telehealth has influenced outcomes in high-risk obstetrics patients during the Coronavirus disease 2019 (COVID-19) pandemic.
Methods: A retrospective chart review was conducted to identify patterns in both telehealth and in-person clinic visits among patients of a Maternal Fetal Medicine (MFM) department from the onset of the COVID-19 pandemic from March 2020 until October 2021. For the descriptive analysis, p-values were calculated using Wilcoxon rank sum for continuous variables and chi-square or Fisher exact (where cell n?<?5) for categorical variables. Variables of interest were then tested for their univariate association with telehealth utilization using logistic regression. Variables found to meet the criterion of p?<?0.2 in the univariate case were introduced into a multivariable logistic model with a backward elimination for determining variable retention. We aimed to analyze whether telehealth visits significantly impacted pregnancy outcomes.
Results: Four hundred nineteen high-risk patients visited the clinic via in-person and/or telehealth appointments during the study period: 320 patients without telehealth visits and 99 patients with telehealth visits. Care provided by telehealth visits was not found to be related to self-reported race (p?=?0.81), maternal body mass index (p?=?1.0), or maternal age (p?=?0.53). Patients with private insurance were more likely to have telehealth visits than patients with public insurance (79.9% vs. 65.5%, p?<?0.01). In univariate logistic analyses, patients with diagnoses of anxiety (p?<?0.01), asthma (p?=?0.03), and depression (p?<?0.01), at the time care was established, were more likely to have telehealth visits. Those patients with telehealth visits did not have any statistical differences in mode of delivery (p?=?0.2) or pregnancy outcomes (p?=?0.12), including fetal demise, preterm delivery, or delivery at term as compared with patients with all in-office visits. In multivariable analysis, patient conditions of anxiety (p?<?0.01), maternal obesity (p?<?0.01), and twin pregnancy (p?=?0.04) were associated with higher rates of telehealth visits.
Conclusion: Patients with certain pregnancy complications elected to have more telehealth visits. Patients with private insurance were more likely to have telehealth visits than patients with public insurance. There are benefits for patients with certain pregnancy complications to incorporate telehealth visits in addition to regularly scheduled in-person clinic visits and may be suitable in a post-pandemic setting as well. Further research in this field is needed to better understand the impact of implementing telehealth in high-risk obstetrics patients. |
| first_indexed | 2024-03-08T11:26:33Z |
| format | Article |
| id | doaj.art-2439ddace31a439589aac1f6ec5a7e05 |
| institution | Directory Open Access Journal |
| issn | 2692-4366 |
| language | English |
| last_indexed | 2024-03-08T11:26:33Z |
| publishDate | 2023-05-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Telemedicine Reports |
| spelling | doaj.art-2439ddace31a439589aac1f6ec5a7e052024-01-26T05:27:57ZengMary Ann LiebertTelemedicine Reports2692-43662023-05-0141616610.1089/TMR.2023.0006Telehealth Utilization in High-Risk Pregnancies During COVID-19Margie A. RayfordJoshua M. MorrisRamona PhinehasElizabeth SchneiderAmanda LundSarah BaxleyJim Y. WanPatricia J. GoedeckeRoberto Levi-D'AnconaPurpose: To determine how telehealth has influenced outcomes in high-risk obstetrics patients during the Coronavirus disease 2019 (COVID-19) pandemic. Methods: A retrospective chart review was conducted to identify patterns in both telehealth and in-person clinic visits among patients of a Maternal Fetal Medicine (MFM) department from the onset of the COVID-19 pandemic from March 2020 until October 2021. For the descriptive analysis, p-values were calculated using Wilcoxon rank sum for continuous variables and chi-square or Fisher exact (where cell n?<?5) for categorical variables. Variables of interest were then tested for their univariate association with telehealth utilization using logistic regression. Variables found to meet the criterion of p?<?0.2 in the univariate case were introduced into a multivariable logistic model with a backward elimination for determining variable retention. We aimed to analyze whether telehealth visits significantly impacted pregnancy outcomes. Results: Four hundred nineteen high-risk patients visited the clinic via in-person and/or telehealth appointments during the study period: 320 patients without telehealth visits and 99 patients with telehealth visits. Care provided by telehealth visits was not found to be related to self-reported race (p?=?0.81), maternal body mass index (p?=?1.0), or maternal age (p?=?0.53). Patients with private insurance were more likely to have telehealth visits than patients with public insurance (79.9% vs. 65.5%, p?<?0.01). In univariate logistic analyses, patients with diagnoses of anxiety (p?<?0.01), asthma (p?=?0.03), and depression (p?<?0.01), at the time care was established, were more likely to have telehealth visits. Those patients with telehealth visits did not have any statistical differences in mode of delivery (p?=?0.2) or pregnancy outcomes (p?=?0.12), including fetal demise, preterm delivery, or delivery at term as compared with patients with all in-office visits. In multivariable analysis, patient conditions of anxiety (p?<?0.01), maternal obesity (p?<?0.01), and twin pregnancy (p?=?0.04) were associated with higher rates of telehealth visits. Conclusion: Patients with certain pregnancy complications elected to have more telehealth visits. Patients with private insurance were more likely to have telehealth visits than patients with public insurance. There are benefits for patients with certain pregnancy complications to incorporate telehealth visits in addition to regularly scheduled in-person clinic visits and may be suitable in a post-pandemic setting as well. Further research in this field is needed to better understand the impact of implementing telehealth in high-risk obstetrics patients.https://www.liebertpub.com/doi/full/10.1089/TMR.2023.0006telehealthtelemedicineobstetricshigh risk |
| spellingShingle | Margie A. Rayford Joshua M. Morris Ramona Phinehas Elizabeth Schneider Amanda Lund Sarah Baxley Jim Y. Wan Patricia J. Goedecke Roberto Levi-D'Ancona Telehealth Utilization in High-Risk Pregnancies During COVID-19 Telemedicine Reports telehealth telemedicine obstetrics high risk |
| title | Telehealth Utilization in High-Risk Pregnancies During COVID-19 |
| title_full | Telehealth Utilization in High-Risk Pregnancies During COVID-19 |
| title_fullStr | Telehealth Utilization in High-Risk Pregnancies During COVID-19 |
| title_full_unstemmed | Telehealth Utilization in High-Risk Pregnancies During COVID-19 |
| title_short | Telehealth Utilization in High-Risk Pregnancies During COVID-19 |
| title_sort | telehealth utilization in high risk pregnancies during covid 19 |
| topic | telehealth telemedicine obstetrics high risk |
| url | https://www.liebertpub.com/doi/full/10.1089/TMR.2023.0006 |
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