Abstract
Introduction The importance of patient satisfaction in US healthcare is increasing, in tandem with the advent of new patient care modalities, including virtual care. The purpose of this study was to compare the satisfaction of obstetric patients who received one-third of their antenatal visits in videoconference (“Virtual-care”) compared to those who received 12–14 face-to-face visits in-clinic with their physician/midwife (“Traditional-care”). Methods We developed a four-domain satisfaction questionnaire; Virtual-care patients were asked additional questions about technology. Using a modified Dillman method, satisfaction surveys were sent to Virtual-care (N = 378) and Traditional-care (N = 795) patients who received obstetric services at our institution between January 2013 and June 2015. Chi-squared tests of association, t-tests, logistic regression, and ANOVA models were used to evaluate differences in satisfaction and self-reported demographics between respondents. Results Overall satisfaction was significantly higher in the Virtual-care cohort (4.76 ± 0.44 vs. 4.47 ± 0.59; p < .001). Parity ≥ 1 was the sole significant demographic variable impacting Virtual-care selection (OR = 2.4, 95% CI: 1.5–3.8; p < .001). Satisfaction of Virtual-care respondents was not significantly impacted by the incorporation of videoconferencing, Doppler, and blood pressure monitoring technology into their care. The questionnaire demonstrated high internal consistency as measured by domain-based correlations and Cronbach’s alpha. Discussion Respondents from both models were highly satisfied with care, but those who had selected the Virtual-care model reported significantly higher mean satisfaction scores. The Virtual-care model was selected by significantly more women who already have children than those experiencing pregnancy for the first time. This model of care may be a reasonable alternative to traditional care.
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References
Alexander, G. R., & Kotelchuck, M. (2001). Assessing the role and effectiveness of prenatal care: history, challenges, and directions for future research. Public health reports (Washington, D. C.: 1974), 116(4), 306–316.
American Academy of Pediatrics and American College of Obstetricians and Gynecologists. (2012). Guidelines for perinatal care (7th edition). Elk Grove Village, IL: American Academy of Pediatrics.
Baldwin, L. M., Raine, T., Jenkins, L. D., Hart, L. G., & Rosenblatt, R. (1994). Do providers adhere to ACOG standards? The case of prenatal care. Obstetrics and Gynecology, 84(4), 549–556.
Butler Tobah, Y. S., LeBlanc, A., Branda, M., Inselman, J., Gostout, B., & Famuyide, A. (2016). OB nest-a novel approach to prenatal care [21]. Obstetrics & Gynecology, 127(Suppl 1), 7S-8S. doi:10.1097/01.aog.0000483637.05137.18.
Carroli, G., Villar, J., Piaggio, G., Khan-Neelofur, D., Gulmezoglu, M., Mugford, M., & Bersgjo, P. (2001). WHO systematic review of randomised controlled trials of routine antenatal care. Lancet, 357(9268), 1565–1570. doi:10.1016/s0140-6736(00)04723-1.
Dillman, D. A. (1978). Mail and telephone surveys: The total design method. New York: Wiley.
Dowswell, T., Carroli, G., Duley, L., Gates, S., Gulmezoglu, A. M., Khan-Neelofur, D., & Piaggio, G. G. (2010). Alternative versus standard packages of antenatal care for low-risk pregnancy. Cochrane Database Syst Rev, 10, CD000934. doi:10.1002/14651858.CD000934.pub2.
Jewell, D., Sharp, D., Sanders, J., & Peters, T. J. (2000). A randomised controlled trial of flexibility in routine antenatal care. BJOG, 107(10), 1241–1247.
Long, M. C., Angtuaco, T., & Lowery, C. (2014). Ultrasound in telemedicine: Its impact in high-risk obstetric health care delivery. Ultrasound Quarterly, 30(3), 167–172. doi:10.1097/ruq.0000000000000073.
Lowery, C., Bronstein, J., McGhee, J., Ott, R., Reece, E. A., & Mays, G. P. (2007). ANGELS and University of Arkansas for Medical Sciences paradigm for distant obstetrical care delivery. American Journal of Obstetrics and Gynecology, 196(6), 534.e1–534.e9. doi:10.1016/j.ajog.2007.01.027.
Magann, E. F., McKelvey, S. S., Hitt, W. C., Smith, M. V., Azam, G. A., & Lowery, C. L. (2011). The use of telemedicine in obstetrics: a review of the literature. Obstetrical & Gynecological Survey, 66(3), 170–178.
Marko, K. I., Ganju, N., Brown, J., Benham, J., & Gaba, N. D. (2016). Remote Prenatal Care Monitoring With Digital Health Tools Can Reduce Visit Frequency While Improving Satisfaction [3]. Obstetrics & Gynecology, 127(Suppl 1), 1S. doi:10.1097/01.AOG.0000483620.40988.df.
McDuffie, R. S. Jr., Beck, A., Bischoff, K., Cross, J., & Orleans, M. (1996). Effect of frequency of prenatal care visits on perinatal outcome among low-risk women. A randomized controlled trial. JAMA, 275(11), 847–851.
McDuffie, R. S. Jr., Bischoff, K. J., Beck, A., & Orleans, M. (1997). Does reducing the number of prenatal office visits for low-risk women result in increased use of other medical services? Obstetrics and Gynecology, 90(1), 68–70. doi:10.1016/s0029-7844(97)00136-1.
Nudell, J., Slade, A., Jovanovic, L., & Hod, M. (2011). Technology and pregnancy. International Journal of Clinical Practice, (170), 55–60. doi:10.1111/j.1742-1241.2010.02579.x.
Odibo, I. N., Wendel, P. J., & Magann, E. F. (2013). Telemedicine in obstetrics. Clinical Obstetrics and Gynecology, 56(3), 422–433. doi:10.1097/GRF.0b013e318290fef0.
Pflugeisen, B., McCarren, C., Poore, S., Carlile, M., & Schroeder, R. (2016). Virtual Visits: Managing antepartum care with modern technology. MCN Am J Matern Child Nurs, 41(1), 24–30.
R Core Team (2013). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. URL http://www.R-project.org/. Retrieved from http://www.R-project.org/.
Ridgeway, J. L., LeBlanc, A., Branda, M., Harms, R. W., Morris, M. A., Nesbitt, K., & Famuyide, A. (2015). Implementation of a new prenatal care model to reduce office visits and increase connectivity and continuity of care: protocol for a mixed-methods study. BMC Pregnancy and Childbirth, 15, 323. doi:10.1186/s12884-015-0762-2.
Sikorski, J., Wilson, J., Clement, S., Das, S., & Smeeton, N. (1996). A randomised controlled trial comparing two schedules of antenatal visits: the antenatal care project. BMJ, 312(7030), 546–553.
Villar, J., Carroli, G., Khan-Neelofur, D., Piaggio, G., & Gulmezoglu, M. (2001). Patterns of routine antenatal care for low-risk pregnancy. Cochrane Database of Systematic Reviews, 4, CD000934. doi:10.1002/14651858.cd000934.
Walker, D. S., McCully, L., & Vest, V. (2001). Evidence-based prenatal care visits: When less is more. Journal of Midwifery & Women’s Health, 46(3), 146–151.
Wood, D. (2011). STORC helps deliver healthy babies: The telemedicine program that serves rural women with high-risk pregnancies. Telemedicine Journal and e-Health, 17(1), 2–4. doi:10.1089/tmj.2011.9996.
Xiong, X., Buekens, P., Fraser, W. D., Beck, J., & Offenbacher, S. (2006). Periodontal disease and adverse pregnancy outcomes: A systematic review. BJOG, 113(2), 135–143. doi:10.1111/j.1471-0528.2005.00827.x.
Acknowledgements
The authors wish to acknowledge the innovators of the Virtual Visit Program—Christi McCarren, Dr. Richard Schroeder, and Dr. Steven Poore—and the ARNP who conducts the Virtual Visits—Malinda Carlile. This work was funded by the MultiCare Institute for Research & Innovation Philanthropic Funds.
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Pflugeisen, B.M., Mou, J. Patient Satisfaction with Virtual Obstetric Care. Matern Child Health J 21, 1544–1551 (2017). https://doi.org/10.1007/s10995-017-2284-1
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DOI: https://doi.org/10.1007/s10995-017-2284-1