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Prenatal care capacity assessment in Philadelphia
Thesis

Prenatal care capacity assessment in Philadelphia

Deshanett L. Clay
Master of Public Health (M.P.H.), Drexel University
Jun 2011
DOI:
https://doi.org/10.17918/etd-3587
pdf
Clay_Deshanett_20111.35 MB
PDF Access upon request, Email title, URL, or DOI to archives@drexel.edu

Abstract

Pennsylvania--Philadelphia Prenatal Care Public Health
Background: Philadelphia has one of the highest infant mortality rates of all urban centers, a measure largely driven by the high rate of both preterm and low birth weight births. In 2008, the infant mortality rate for the city of Philadelphia was 10.8, compared to a rate of 7.3 for Pennsylvania and 6.6 for the United States. The closings of 13 hospitals in Philadelphia since 1997 may have dramatically affected prenatal care capacity and may in part be responsible for the inadequate maternal and child health practices in the city. Objective: The primary goal of this pilot study was to assess the capacity of prenatal care services, both public and private, in the City of Philadelphia. Methods: A web-based survey was completed by public and private facilities providing prenatal care services in the City of Philadelphia. Preliminary Findings: Public (n=16) and private (n=16) participant facilities had an average wait time of 13.5 days and 7 days for the first available prenatal care appointment, respectively. Of these participants (N=32), 93.75% do not offer weekend hours and 78.13% do not offer evening hours extending past 5:00 PM. This study has several limitations. For example, recruitment and data collection methods were extremely limited under the constraints of the Exempt Category 2 protocol, receiving responses from potential participants posed multiple challenges, and commercial insurance plans were unable to provide an electronic listing of their participating prenatal care practitioners and facilities. Conclusions/Recommendations: The preliminary findings suggest the need for system changes in order to better support early prenatal care. Multiple measures, including conducting annual capacity studies, assessing patients' and practitioners' perceptions of barriers to care, increasing the supply of practitioners providing prenatal care, and convening roundtables or an advisory committee may help to improve access to prenatal care and thereby improve the health of Philadelphia's infants.

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