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Neonatology

Session: Neonatal-Perinatal Health Care Delivery 1 Works in Progress

WIP 32 - Impact of Geographic Distance on Outpatient Maternal Prenatal Consultations with a Perinatal Palliative Care Team After a Fetal Life-Limiting Diagnosis

Monday, May 6, 2024
9:30 AM – 11:30 AM ET
Poster Number: WIP 32
Publication Number: WIP 32.2598


Background: Perinatal Palliative Care (PPC) is a relatively new field and literature describing experiences in this area is needed.

Our hospital developed a perinatal palliative care team in 2012 to provide consultations for neonatal patients and expectant families facing a potentially life-limiting diagnosis. Despite the availability of this program, barriers to access and utilization exist. Prior work has shown that geographic barriers to regionalized centers of care affects maternal access to prenatal care in both rural and urban populations, ultimately impacting perinatal outcomes. Further work to understand the impact of geographic barriers to perinatal palliative care and the effect of telemedicine on access is needed to improve delivery of this increasingly important service.

Objective: Analyze the effect of geographic distance to PPC services on utilization of these resources and describe family experiences over time. We hypothesize that our PPC team has had increasing geographic reach in more recent years. We expect that families with greater distance to PPC resources are more likely to have delayed access to care after fetal life-limiting diagnosis, fewer PPC consultations, and different birth plans. We will analyze the effect that the addition of telemedicine services has on these metrics.

Design/Methods: This study is a retrospective, cohort analysis of all maternal outpatient consultations with our PPC team, IMPACT, between May 2012 – April 2023 at our high risk referral center, ChristianaCare Hospital. Maternal consultations were included if the fetus had a life limiting diagnosis, referral to IMPACT was made, and one or more consultations occurred. Data was collected from the mother’s and infant’s medical records with IRB permission. The data is currently undergoing descriptive and quantitative analysis.