How Does Redesignation From Gynecology Emergency Room to Gynecology Urgent Care Change Postpartum Representation Rates? [ID 792]

INTRODUCTION: The escalating demands on emergency and urgent care services strain health care resources. Patient choices regarding access to these services hinge upon multiple factors, such as perceived urgency, convenience, and limited availability of primary care. We investigate the effects of transitioning a hospital’s gynecologic care center from an emergency room to an urgent care on postpartum representation and readmission rates. METHODS: In an IRB-exempt retrospective cohort study at a Level IV maternal care hospital, we assessed postpartum presentation rates over a 10-month period, with the care center functioning as a gynecologic emergency room for the first 5 months before transitioning to a gynecology urgent care. Using chart reviews, we compared postpartum presentations and admission rates before and after the transition. RESULTS: Between July and November 2023, a total of 2,485 patients delivered during the emergency room designation, and 2,057 deliveries occurred between December 2023 and April 2024 during the urgent care designation. Significantly more postpartum patients presented to the gynecology urgent care (8.02% of all deliveries) compared to the gynecology emergency room (5.55%) ( P =.001). Admission rates from postpartum presentations did not statistically significantly differ ( P =.599), but clinically significant increases in readmissions for cesarean surgical site infection (13% to 41%) and decreases for preeclampsia with severe features (60% to 11%) were observed. CONCLUSIONS/IMPLICATIONS: Designating hospital gynecologic care centers as gynecology urgent care leads to a significant increase in postpartum patient presentation rates, possibly due to perceived accessibility. Further investigation is needed to understand patient awareness of this status change and its effect on postpartum visit attendance.