Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical Center

Area of Science:

• Health Services Research
• Patient Navigation
• Maternal Health

Background:

• The postpartum period is critical for long-term health and healthcare utilization.
• System complexities often impede postpartum patients' ability to manage their health effectively.
• Postpartum patient navigation offers a potential solution to mitigate barriers in longitudinal care.

Purpose of the Study:

• To identify and describe gaps within the healthcare system that impact postpartum individuals' longitudinal health.
• To analyze the experiences of postpartum patient navigators and navigated participants to understand system-level challenges.

Main Methods:

• Secondary analysis of interviews from a randomized controlled trial (RCT).
• Conducted semi-structured interviews with postpartum navigators (n=2) and a subset of navigated participants (n=15).
• Utilized grounded theory for qualitative analysis of transcribed interviews.

Main Results:

• Identified three major care system gaps: overall health system issues, postpartum care specific challenges, and primary care transition difficulties.
• Health system challenges included fragmentation, high patient burden, and poor communication.
• Postpartum care challenges involved operational errors and the episodic nature of obstetric care, while primary care transitions lacked emphasis and support.

Conclusions:

• Postpartum patient navigators highlighted critical health system deficiencies affecting birthing individuals' long-term health.
• Results underscore the need for systemic improvements to enhance postpartum care and promote lifelong well-being.