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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 10 of 10 Research Studies DisplayedPeahl AF, Smith RD, Moniz MN
Prenatal care redesign: creating flexible maternity care models through virtual care.
Each year, over 98% of the almost 4 million pregnant patients in the United States receive prenatal care-a crucial preventive service to improve outcomes for moms and babies. In this paper, the authors outline their experience rapidly transitioning prenatal care to a new model with 4 in-person visits, 1 ultrasound visit, and 4 virtual visits (the 4-1-4 prenatal plan). They then explore how lessons from this implementation can inform patient-centered prenatal care redesign during and beyond the COVID-19 pandemic.
AHRQ-funded; HS025465.
Citation: Peahl AF, Smith RD, Moniz MN .
Prenatal care redesign: creating flexible maternity care models through virtual care.
Am J Obstet Gynecol 2020 Sep;223(3):389.e1-89.e10. doi: 10.1016/j.ajog.2020.05.029..
Keywords: Maternal Care, Telehealth, Health Information Technology (HIT), Pregnancy, Women, Healthcare Delivery, Patient-Centered Healthcare
Upadhya KK, Psoter KJ, Connor KA
AHRQ Author: Mistry KB
Cluster randomized trial of a pre/interconception health intervention for mothers in pediatric visits.
Recognizing that pediatric primary care focuses on family health and is an important location of contact for women of childbearing age, this project assessed the effectiveness of a pre/interconception women's health intervention delivered during pediatric primary care using a cluster randomized trial. The investigators concluded that pediatric visits are an opportune location for addressing maternal health. They indicated that this intervention demonstrated feasibility and improved outcomes for some but not all outcome.
AHRQ-authored.
Citation: Upadhya KK, Psoter KJ, Connor KA .
Cluster randomized trial of a pre/interconception health intervention for mothers in pediatric visits.
Acad Pediatr 2020 Jul;20(5):660-69. doi: 10.1016/j.acap.2019.10.003..
Keywords: Family Health and History, Pregnancy, Women, Primary Care: Models of Care, Primary Care, Healthcare Delivery
Friedman Peahl A, Heisler M, Essenmacher LK
A comparison of international prenatal care guidelines for low-risk women to inform high-value care.
The authors compared U.S. to international prenatal care consensus guidelines for low-risk women to inform care delivery reforms. They found that U.S. and peer-country guidelines recommended similar prenatal education and psychosocial services for low-risk women; however, peer countries generally recommended fewer visits, longer intervals between visits, and less reliance on obstetrician-gynecologists for routine, low-risk prenatal care. They recommended that further investigation evaluate associations between recommended care and actual practice, as well as the effects of different components of prenatal care and delivery models on maternal-infant outcomes, patient-centeredness, and health care expenditures in the U.S.
AHRQ-funded; HS025465.
Citation: Friedman Peahl A, Heisler M, Essenmacher LK .
A comparison of international prenatal care guidelines for low-risk women to inform high-value care.
Am J Obstet Gynecol 2020 May;222(5):505-07. doi: 10.1016/j.ajog.2020.01.021..
Keywords: Maternal Care, Pregnancy, Women, Guidelines, Evidence-Based Practice, Healthcare Delivery
Peahl AF, Novara A, Heisler M
Patient preferences for prenatal and postpartum care delivery: a survey of postpartum women.
The objective of this study was to describe patients' preferences for prenatal and postpartum care delivery. The investigators concluded that current prenatal and postpartum care delivery did not match patients' preferences for visit number or between-visit contact, and patients were open to alternative models of prenatal care, including remote monitoring.
AHRQ-funded; HS025465.
Citation: Peahl AF, Novara A, Heisler M .
Patient preferences for prenatal and postpartum care delivery: a survey of postpartum women.
Obstet Gynecol 2020 May;135(5):1038-46. doi: 10.1097/aog.0000000000003731.
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Keywords: Pregnancy, Maternal Care, Women, Healthcare Delivery
Darney BG, Fuentes-Rivera E, Polo G
Con la ley y sin la ley/With and without the law: utilization of abortion services and case fatality in Mexico, 2000-2016.
This study examined abortion and case-fatality rate trends in Mexico and Mexico City from 2000 to 2016. The rate nationally was 6.7 per 1000 in 2000, peaked in 2011, and plateaued in 2016. In Mexico City the utilization rate peaked in 2014 and then plateaued. Nationwide and in Mexico City (where abortion was legalized in 2007) case-fatality rates declined over time. After abortion became legal in Mexico City, the rate decreased more rapidly than in the other states of Mexico.
AHRQ-funded.
Citation: Darney BG, Fuentes-Rivera E, Polo G .
Con la ley y sin la ley/With and without the law: utilization of abortion services and case fatality in Mexico, 2000-2016.
Int J Gynaecol Obstet 2020 Mar;148(3):369-74. doi: 10.1002/ijgo.13077..
Keywords: Pregnancy, Healthcare Utilization, Women, Healthcare Delivery
Gordon SH, Sommers BD, Wilson IB
Effects of Medicaid expansion on postpartum coverage and outpatient utilization.
Timely postpartum care is associated with lower maternal morbidity and mortality, yet fewer than half of Medicaid beneficiaries attend a postpartum visit. Using Medicaid claims data for 2013-2015 from Colorado, which expanded Medicaid under the Affordable Care Act, and Utah, which did not, the authors conclude that expansion may promote the stability of postpartum coverage and increase the use of postpartum outpatient care in the Medicaid program.
AHRQ-funded; HS025560.
Citation: Gordon SH, Sommers BD, Wilson IB .
Effects of Medicaid expansion on postpartum coverage and outpatient utilization.
Health Aff 2020 Jan;39(1):77-84. doi: 10.1377/hlthaff.2019.00547..
Keywords: Medicaid, Pregnancy, Women, Access to Care, Maternal Care, Ambulatory Care and Surgery, Policy, Healthcare Delivery
Alexander LT, Fuentes-Rivera E, Saavedra-Avendano B
Utilisation of second-trimester spontaneous and induced abortion services in public hospitals in Mexico, 2007-2015.
This study examined data on utilization of in-facility second-trimester abortion services in Mexico. Data from Mexico’s Automated Hospital Discharge System (SAEH) from 2007-2015 was used to identify second-trimester abortions in public hospitals across Mexico’s 32 states. A total 145,956 second-trimester abortion services or 13.4% of total documented hospitalizations for abortion were identified. The rate remained constant for women aged 15-44 years. Women living in poorer socioeconomic conditions or highly marginalized municipalities were most likely to have second-trimester abortions compared to women in higher socioeconomic conditions who were able to utilize services in their first trimester.
AHRQ-funded; HS025155; HS022981.
Citation: Alexander LT, Fuentes-Rivera E, Saavedra-Avendano B .
Utilisation of second-trimester spontaneous and induced abortion services in public hospitals in Mexico, 2007-2015.
BMJ Sex Reprod Health 2019 Oct;45(4):283-89. doi: 10.1136/bmjsrh-2018-200300..
Keywords: Pregnancy, Women, Healthcare Utilization, Hospitals, Healthcare Delivery
Connor KA, Duran G, Faiz-Nassar M
Feasibility of implementing group well baby/well woman dyad care at federally qualified health centers.
The aim of this qualitative study was to assess stakeholder perspectives on the feasibility of implementing Centering Parenting (CP) in federally qualified health centers (FQHCs) in Baltimore. The investigators concluded that perceptions regarding facilitators and barriers to CP implementation in FQHCs were similar to existing group well-child care literature; however the benefit of emphasis on maternal wellness was a unique finding. The investigators suggested that a maternal wellness integration might make CP a particularly desirable model for implementation at FQHCs, but potential systems barriers must be addressed.
AHRQ-funded; HS017596.
Citation: Connor KA, Duran G, Faiz-Nassar M .
Feasibility of implementing group well baby/well woman dyad care at federally qualified health centers.
Acad Pediatr 2018 Jul;18(5):510-15. doi: 10.1016/j.acap.2017.09.011..
Keywords: Caregiving, Children/Adolescents, Education: Patient and Caregiver, Health Promotion, Healthcare Delivery, Maternal Care, Newborns/Infants, Pregnancy, Women
Phillippi JC, Hartmann KE
Differentiating research, quality improvement, and case studies to ethically incorporate pregnant women.
This article discusses the need to involve pregnant women in research, quality improvement, and case studies and how to involve them in an ethical way with high standards to protect participants. This review includes vignettes to distinguish between the different types of studies and emphasizes that perinatal care providers will need to seek institutional review board approval for all research to be conducted.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Hartmann KE .
Differentiating research, quality improvement, and case studies to ethically incorporate pregnant women.
J Midwifery Womens Health 2018 Jan;63(1):104-14. doi: 10.1111/jmwh.12673..
Keywords: Health Services Research (HSR), Healthcare Delivery, Maternal Care, Pregnancy, Quality of Care, Quality Improvement, Research Methodologies, Women
Metz TD, Gonzalez C, Allshouse AA
Influence of patient-level factors on mode of delivery among operative vaginal delivery candidates in modern practice.
This study aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Odds of forceps versus vacuum were higher with induction, nulliparity, epidural, maternal indication, older maternal age, and longer second stage. Odds of cesarean versus operative vaginal delivery were higher with maternal indication, a perinatologist, longer second stage, older gestational age and longer labor.
AHRQ-funded; HS022143.
Citation: Metz TD, Gonzalez C, Allshouse AA .
Influence of patient-level factors on mode of delivery among operative vaginal delivery candidates in modern practice.
Am J Perinatol 2017 Aug;34(10):974-81. doi: 10.1055/s-0037-1601441.
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Keywords: Adverse Events, Healthcare Delivery, Labor and Delivery, Pregnancy, Women