Group Prenatal Care: A Promising Quality Measure in Ambulatory Obstetrics [28A]

Abstract

INTRODUCTION: The group prenatal care (GPC) practice model has demonstrated success in achieving quality goals such as improved outcomes, care satisfaction and reduced costs. We sought to improve care quality among women receiving prenatal care in an urban, obstetrical residency training practice by implementing a GPC option. METHODS: We conducted a retrospective study comparing women in a GPC pilot cohort to a risk-based, matched cohort of women receiving individual prenatal care in the same practice from 2015 to 2018. Maternal and newborn outcomes and cost were assessed. Descriptive analysis was used to characterize the cohorts and bivariate analysis was used to compare outcomes and costs. Date were obtained from electronic medical records and hospital financial systems. RESULTS: Rates of cesarean delivery (17.9% vs 33%, p = 0.04) and neonatal intensive care unit (NICU) admissions (1.8% vs 17%, p = <0.01) were decreased among women in the GPC cohort compared to those in individual care. Reduced NICU admissions saved the Medicaid program approximately $256,216 or $37,027 per avoided admission. CONCLUSION: Few ambulatory quality metrics are defined in obstetrical care. GPC implemented in an urban, residency training practice setting improved outcomes and reduced costs compared to those in individual prenatal care. GPC is a promising model to improve quality among ambulatory obstetrics training practices.