Whole-Person Perinatal Care Coordination: Addressing Barriers to Care Through Screening for Social Determinants of Health [ID 923]

INTRODUCTION: Preterm birth and maternal mortality rates have risen for the past three decades despite biomedical interventions, driven by inequitable access to health care and resources. Up to 89% of health is due to factors outside of the clinical context, called the social determinants of health (SDoH). A pilot study was conducted to determine the effect on birth outcomes using an SDoH screen and care coordination on an outpatient obstetric population. METHODS: The study was conducted over 18 months in a private practice in Florida. A total of 553 patients were assessed using two standardized SDoH screens. In-office care coordinators collected data and referred patients to community resources. Cesarean birth rates, prenatal care attendance, and postpartum visit attendance were collected in the study population. This was compared with 12 months of retrospective and 18 months of prospective data pulled from a larger aggregate private practice data set. Comparative analysis was performed. RESULTS: The cesarean birth rate was 34.9% versus 36.1%, study versus control group. Attendance of first-trimester prenatal visits increased by 15.7% (48.3% versus 64.0%). Attendance of postpartum visits increased by 9.0% (85.1% versus 94.0%). There was no difference in preterm birth rates. CONCLUSIONS/IMPLICATIONS: This study adds to the growing body of literature on nontechnological interventions for affecting birth outcomes. Screening for and addressing the SDoH increased access to health and resources, which has the potential to reduce preterm birth and maternal mortality rates. Future studies will utilize algorithm-driven risk stratification of obstetric patients to realize improved and equitable maternal and neonatal outcomes.