From the Department of Family Medicine, Oregon Health & Science University, Portland, Oregon (KEP, EKC, BAH); OCHIN, Inc, Research Division, Portland, Oregon (FMB, MH, ART, EKC, BAH); Division of Complex Family Planning, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon (BGD).
J Am Board Fam Med. 2023 Aug 9;36(4):574-582. doi: 10.3122/jabfm.2023.230025R1.
Community health centers (CHCs) provide critical health care access for people who experience high risks during and after pregnancy, however it is unclear to what extent they provide prenatal care. This study seeks to describe clinic and patient characteristics associated with longitudinal prenatal care delivery in CHC settings.
This retrospective cohort study utilized electronic health record (EHR) data from the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) between 2018 to 2019 to describe prenatal care provision among CHCs ( = 408), and pregnant CHC patients ( = 28,578) and compared characteristics of patients who received longitudinal prenatal care at CHCs versus those who did not.
41% of CHCs provided longitudinal prenatal care; these CHCs were more likely to be larger, have multidisciplinary teams, and serve higher proportions of nonwhite or non-English speaking patients. Patients who received longitudinal prenatal care at CHCs were racially and ethnically diverse and many had comorbidities. Patients who received longitudinal prenatal care at CHCs (compared with pregnant patients who did not) were more likely to be white or Latinx and more likely to have non-English language preference.
Many CHCs in this national network provide prenatal care and serve pregnant patients at high risk of pregnancy-related complications, including people of color, those with low income, and those with comorbidities. CHCs provide critical access to care for vulnerable populations and will be an important partner in work addressing inequities in maternal morbidity and mortality.
社区卫生中心（CHC）为在妊娠期间和之后经历高风险的人群提供了重要的医疗保健机会，但目前尚不清楚它们在多大程度上提供了产前护理。本研究旨在描述与 CHC 环境中纵向产前护理提供相关的诊所和患者特征。
本回顾性队列研究利用 ADVANCE 项目在 2018 年至 2019 年间的电子健康记录（EHR）数据，描述了 CHC（n=408）中的产前护理提供情况，以及 CHC 患者（n=28578）中的孕妇，并比较了在 CHC 接受纵向产前护理的患者和未接受纵向产前护理的患者的特征。
41%的 CHC 提供了纵向产前护理；这些 CHC 更有可能规模更大，拥有多学科团队，并为更高比例的非白人或非英语患者提供服务。在 CHC 接受纵向产前护理的患者在种族和民族上具有多样性，许多人患有合并症。与未在 CHC 接受纵向产前护理的孕妇相比，在 CHC 接受纵向产前护理的患者更有可能是白人或拉丁裔，并且更有可能有非英语语言偏好。
在这个全国性网络中，许多 CHC 提供产前护理，并为有妊娠相关并发症高风险的孕妇提供服务，包括有色人种、低收入人群和患有合并症的人群。CHC 为弱势人群提供了重要的医疗保健机会，将成为解决产妇发病率和死亡率不平等问题的重要合作伙伴。
