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Updated: Aug 16, 2025

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
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Reducing Disparities in Postpartum Care Utilization: Development of a Clinical Risk Assessment Tool.

Sandi Tenfelde1, Cara Joyce2, Dina Tell1

  • 1Loyola University Chicago, Marcella Niehoff School of Nursing, Maywood, Illinois.

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|December 24, 2022
PubMed
Summary

Federally Qualified Health Centers (FQHCs) identified a clinical decision support tool to predict postpartum care attendance. This tool aids in identifying patients at risk for non-attendance, aiming to improve maternal health outcomes.

Keywords:
federally qualified health centerspostpartum visitpredictive modelingsecondary data analysis

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Area of Science:

  • Public Health
  • Health Services Research
  • Maternal Health

Background:

  • Low postpartum care attendance is prevalent in Federally Qualified Health Centers (FQHCs).
  • Perinatal morbidity and mortality disproportionately affect low-income populations and are potentially preventable.
  • Identifying at-risk patients is crucial for improving maternal health outcomes.

Purpose of the Study:

  • To develop a clinical decision support tool to identify FQHC patients with low likelihood of postpartum care attendance.
  • To evaluate established and novel risk factors for postpartum care non-attendance within an FQHC population.

Main Methods:

  • Retrospective analysis of 50,022 patients receiving prenatal care in FQHCs (2012-2017).
  • Utilized Anderson's Behavioral Model for Access to Healthcare to guide the selection of predictive factors.
  • Defined postpartum visits using Healthcare Effectiveness Data and Information Set (HEDIS) measures for early (0-21 days) and later (21-84 days) care.

Main Results:

  • 64% of patients attended postpartum care at FQHCs.
  • Predictors for attendance included maternal age, parity, gestational age at first visit, and number of prenatal visits.
  • A clinical decision support tool was developed to identify patients at risk for non-attendance.

Conclusions:

  • An easily implementable clinical decision support tool can identify FQHC patients at risk for postpartum non-attendance.
  • Interventions promoting early and adequate prenatal care may improve postpartum attendance and maternal health.
  • Targeted support for high-risk patients is essential for improving postpartum care utilization.