Social inequities between prenatal patients in family medicine and obstetrics and gynecology with similar outcomes

Michael Partin, Ana Sanchez, Jessica Poulson, Arthur Berg, Jessica Parascando, Sarah Ines Ramirez

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Family Medicine (FM) physicians play a vital role in caring for vulnerable populations across diverse practice settings. The significant decline in FM physicians performing deliveries compounds the estimated shortage of 9000 prenatal care providers expected by 2030. This study investigated the social risk profile, as characterized by social determinants of health, of patients receiving prenatal care from FM versus Obstetrics and Gynecology (OB/Gyn) providers. Methods: Retrospective chart review of patients receiving prenatal care between 2015 to 2018 at Penn State Health Hershey Medical Center comparing social determinants of health between FM and OB/Gyn. Results: A total of 487 patient charts were reviewed with final analysis completed on 215 charts from each cohort. When compared with OB/Gyn, prenatal patients cared for by FM were more likely to be younger (27 vs 29 years old; P <.0001), African American (28% vs 8%; P <.0001), single (52% vs 37%; P <.01), have high school or less education (67% vs 49%; P <.01), use Medicaid (46% vs 23%; P <.0001), and use tobacco during pregnancy (17% vs 8%; P <.01). In addition, FM patients had a lower rate of total Cesarean-sections (C-section), including primary and repeat, when compared with OB/Gyn (23% vs 32%; P =.04). Conclusions: Our work demonstrates that when compared with OB/Gyn at our institution, FM physicians provide care to a cohort of patients with an increased burden of social risk without compromise to care as evidenced by a lower C-section rate and similar gestational age at delivery.

Original languageEnglish (US)
Pages (from-to)181-188
Number of pages8
JournalJournal of the American Board of Family Medicine
Volume34
Issue number1
DOIs
StatePublished - Jan 2021

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Family Practice

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