| Autor: |
Peahl AF; Department of Obstetrics and Gynecology, the Institute for Healthcare Policy and Innovation, the Michigan National Clinician Scholars Program, and the Center for Value-Based Insurance Design, University of Michigan, Ann Arbor, Michigan; the Department of Health Care Policy, Harvard Medical School, and the Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and the Department of Obstetrics and Gynecology, Division of General Obstetrics and Gynecology, University of South Florida, Tampa, Florida., Gourevitch RA, Luo EM, Fryer KE, Moniz MH, Dalton VK, Fendrick AM, Shah N |
| Jazyk: |
angličtina |
| Zdroj: |
Obstetrics and gynecology [Obstet Gynecol] 2020 May; Vol. 135 (5), pp. 1027-1037. |
| DOI: |
10.1097/AOG.0000000000003820 |
| Abstrakt: |
Prenatal care is one of the most widely used preventive care services in the United States, yet prenatal care delivery recommendations have remained largely unchanged since just before World War II. The current prenatal care model can be improved to better serve modern patients and the health care providers who care for them in three key ways: 1) focusing more on promotion of health and wellness as opposed to primarily focusing on medical complications, 2) flexibly incorporating patient preferences, and 3) individualizing care. As key policymakers and stakeholders grapple with higher maternity care costs and poorer outcomes, including lagging access, equity, and maternal and infant morbidity and mortality in the United States compared with other high-income countries, the opportunity to improve prenatal care has been given insufficient attention. In this manuscript, we present a new conceptual model for prenatal care that incorporates both patients' medical and social needs into four phenotypes, and use human-centered design methods to describe how better matching patient needs with prenatal services can increase the use of high-value services and decrease the use of low-value services. Finally, we address some of the key challenges to implementing right-sized prenatal care, including capturing outcomes through research and payment. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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