A Model for the Provision of Prenatal Care

0
0
2615 days ago, 1028 views
PowerPoint PPT Presentation
A Model for the Procurement of Pre-birth Consideration. An organization between a private doctor hone, a group doctor's facility and a neighborhood wellbeing division to give pre-birth consideration to a helpless populace. Ann Addison, CNM Mimi Collins, Chief The Longstreet Center, PC.

Presentation Transcript

Slide 1

A Model for the Provision of Prenatal Care An association between a private doctor hone, a group clinic and a nearby wellbeing division to give pre-birth care to a defenseless populace. Ann Addison, CNM Mimi Collins, CEO The Longstreet Clinic, PC Georgia Perinatal Association 2005 Annual Conference

Slide 2

Hall County Population Growth From Norton Agency – "Local Intelligence Forecast" Georgia Perinatal Association 2005 Annual Conference

Slide 3

Changing Demographics From Norton Agency – "Local Intelligence Forecast" Georgia Perinatal Association 2005 Annual Conference

Slide 4

About Hall County (from US Census Bureau) Population of 156,101 in light of 2003 Census gauges 71% of populace is White – not of Hispanic/Latino inception 19.6% of populace is of Hispanic/Latino birthplace 7.3% of populace is Black or African American 16.2% of populace is contained Foreign Born Persons versus 7.1% for all of Georgia 20.7% of the populace talks a dialect other than English in the home. 12.4% of the populace in 1999 was beneath neediness level Georgia Perinatal Association 2005 Annual Conference

Slide 5

Department of Community Health 2002 Data 23,598 Medicaid Recipients in Hall County 4621 Peachcare for Kids Recipients in Hall County Georgia Perinatal Association 2005 Annual Conference

Slide 6

Northeast Georgia Medical Center Statistics 3943 conveyances in 2004: 32% of which were to Hispanic moms 55% of which were to patients secured by Medicaid Georgia Perinatal Association 2005 Annual Conference

Slide 7

Initial Goal of the Prenatal Program The underlying objective of the program was to give an instrument to conveyance of okay crisis room stroll in patients. Georgia Perinatal Association 2005 Annual Conference

Slide 8

457 conveyances of these lone 53 had no PNC Patients conveyed with no PNC drops to 35 every year 1065 ladies treated in the program. - 969 children conveyed 344 stroll in conveyances with no PNC 1987 1991 1995 2004 The Longstreet Clinic assumes control program and representatives CNMs. TLC doctors oversee program with HHD. TLC Ob doctors move to a more coordinated CNM/MD demonstrate though tolerant couldn't care less. NGMC Contracts for CNMS to give intrapartum care to generally safe stroll in patients. Program advances into giving pre-birth mind at HHD. High hazard patients watched over by Ob Medical Staff through a free course of action/responsibility. Georgia Perinatal Association 2005 Annual Conference

Slide 9

The Partnership Hall County Health Department Prenatal Clinic Provides fractional subsidizing for Provision of Prenatal & Antepartum Care Provides Obstetrical Medical Care Provides Stipend for CNM Staffing HD Hospital Services Georgia Perinatal Association 2005 Annual Conference

Slide 10

TLC Obstetrical Practice 8 Obstetrical doctors 10 CNMs 4 Practice Locations (Gainesville, Baldwin, Dahlonega, Hall County Health Department) Attends 70% of all conveyances at NGMC. MD/CNM relationship depends on a community oriented model. TLC has gone to: 2003 – 2638 conveyances 2004 – 2716 conveyances 2005 – 1400 conveyances - YTD June Georgia Perinatal Association 2005 Annual Conference

Slide 11

About the Prenatal Program Patients 94% - 95% of the patients administered to in the program are Hispanic. Most don't meet all requirements for Medicaid or other installment sources. Many are non-English talking. Most are hitched. Many are working and additionally their life partner is working in the group. Georgia Perinatal Association 2005 Annual Conference

Slide 12

Goals of Health Department Reduce number of ladies without access to pre-birth mind Increase number of these ladies who enter mind inside 1 st or 2 nd trimester Improve Health Statistics: Increased Birth Weight Reduced Infant Mortality Improve Health Status of Newborns Georgia Perinatal Association 2005 Annual Conference

Slide 13

Goals of Physicians Improve incorporation between the wellbeing division, doctors and the doctor's facility to: Reduce number of "walk-ins" into ER Limit budgetary misfortunes related with giving consideration to this populace Improve stream of required clinical data to the doctor's facility/going to doctor Manage danger of doctors Improve result of patients and their babies Georgia Perinatal Association 2005 Annual Conference

Slide 14

Goals of Hospital Reduce conveyances with no pre-birth mind Manage doctor's facility hazard related with a high hazard populace Reduce monetary misfortunes related with giving consideration to this populace Improve wellbeing status of infants Georgia Perinatal Association 2005 Annual Conference

Slide 15

Hospital "Walk-Ins" (patients displaying to ER for conveyance with lacking pre-birth mind) Hospital Deliveries 2023 conveyances 1987 3943 conveyances 2004 Walk – ins 344 walk-ins 1987 40 walk-ins 2004 Today, ¼ of the ladies conveying in our group are watched over through the Prenatal Program Georgia Perinatal Association 2005 Annual Conference

Slide 16

Patient Enrollment In 1996, the Prenatal Program enlisted a normal of 55 new Ob patients for each month. Today, the Program selects 80-90 new Ob patients for every month. Georgia Perinatal Association 2005 Annual Conference

Slide 17

Prenatal Program Statistics Georgia Perinatal Association 2005 Annual Conference

Slide 18

Entry Into Care Georgia Perinatal Association 2005 Annual Conference

Slide 19

Funding Majority of patients getting to mind at the Health Department don't meet all requirements for Medicaid or some other installment source. Patients are approached to pay $1000 for pre-birth mind paying little heed to when they enter program. Patients that can't pay may fit the bill for help through Babies Born Healthy or Indigent Care Trust Fund monies. Most Patients will fit the bill for Emergency Medicaid sooner or later in pregnancy or at conveyance. Georgia Perinatal Association 2005 Annual Conference

Slide 20

HOWEVER; There are a gathering of patients that: Do not pay for pre-birth bundle, AND Do not fit the bill for any support. TLC charges quiet straightforwardly for MD visits and ultrasounds past initial 2, if the patient has not fit the bill for Emergency Medicaid. Healing facility charges understanding for extra labs. Because of timing and consistence of patients, a few patients don't meet all requirements for Emergency Medicaid anytime. Georgia Perinatal Association 2005 Annual Conference

Slide 21

Improve Clinical Outcomes This gathering of ladies will convey at our group healing center regardless of whether they get pre-birth mind – By cooperating, clinical results are enhanced which diminishes and oversee hazard to the suppliers which thusly controls money related effect to our group. Control Financial Impact Manage Risk Georgia Perinatal Association 2005 Annual Conference

Slide 22

Comprehensive Prenatal Package Scheduled and issue Ob visits Routine NOB Labs: ABO & Rh ABS RPR HBsAg Rubella Urine Culture Additional Labs 1 hour glucose screen Hemoglobin ABS @ 26-28 weeks for Rh negative ladies Up to 2 ultrasounds Prenatal Vitamins and Iron (if necessary) Georgia Perinatal Association 2005 Annual Conference

Slide 23

Additional Costs Not Included in Package Triple Screen 3 Hr GTT PIH Labs HgbA1C 24 hour pee gathering for protein GBS culture Non-push testing Additional Ultrasounds Rhogam for Rh Negative ladies Level II Ultrasounds Georgia Perinatal Association 2005 Annual Conference

Slide 24

Initial Contact Pregnancy test Eligibility criteria Prenatal vitamins WIC Georgia Perinatal Association 2005 Annual Conference

Slide 25

New Ob Visit Medical History Surgical History Obstetric History Family History Social History Physical Exam NOB Labs Identification of Problems Plan of Care Georgia Perinatal Association 2005 Annual Conference

Slide 26

Certified Nurse Midwifes Available for counsel Staffed in Clinic 5 days for every week CNM visit at 28 weeks following 1 hour glucose screen is finished CNM visit at 40 weeks and week after week from there on See any patient who is considered at hazard Manage pre-birth, intrapartum and baby blues mind Independently as a team with doctor Refer for medicinal administration Georgia Perinatal Association 2005 Annual Conference

Slide 27

Staffing at the Health Department from TLC CNMs 5 days for every week Ultrasonographer 4 days for each week NSTs 5 days for each week MD 1 day for each week Certified Diabetic Educator and Nurse Practitioner 1 day for every week Is conceding doctor for Health Department patients. Georgia Perinatal Association 2005 Annual Conference

Slide 28

Challenges that Face Us Late to Care Absence from Care Undocumented Women Limited Political Support Potential Medicaid Reductions to State Budget Potential Increases in Uninsured Continued social hindrances to getting to mind in a "customary setting" Georgia Perinatal Association 2005 Annual Conference

Slide 29

Why is this Program Important? Access to quality social insurance High-quality, financially savvy pre-birth mind Increase in number of ladies who get pre-birth mind Decrease in number of ladies who are "walk-ins" Decrease in rate of wiped out and low birth weight newborn children Decrease in rate of babies admitted to NICU Identification of ladies with perpetual medical issues Georgia Perinatal Association 2005 Annual Conference

Slide 30

Our Outcomes Hall County is reliably underneath the State rate for Infant Mortality Rate. Georgia Perinatal Association 2005 Annual Conference

Slide 31

Family Connection Partnership 2004 GEORGIA KIDS COUNT - REPORT Georgia Perinatal Association 2005 Annual Conference

Slide 32

According to Georgia Family Connection Partnership, Hall County's 2004 Healthy Start Index is 90.9% contrasted with 71.4% for the re

SPONSORS