Medical care · 2026
Peripartum Telehealth Care Utilization During the COVID-19 Pandemic, by Hypertension Status, PCORnet®, 2018 to 2023.
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Kuklina Elena V, Lekiachvili Akaki, Rohan Angela, Womack-Martenson Lindsay S, Jackson Sandra L, Clark Elizabeth A, Block Jason P, Carton Thomas, Cowell Lindsay, Draper Christine, Rasmussen Sonja A, Smith Samantha, Thacker Deepika, Wiltz Jennifer L, PCORnet writing committee coauthors, on behalf of PCORnet Network Partners
Аннотация
OBJECTIVE: To examine telehealth care utilization during pregnancy and in the 6 months postpartum during the COVID-19 pandemic.
RESEARCH DESIGN: We used a repeated cross-sectional design to assess aggregated and standardized electronic health records (EHR) from 28 participating US health systems in the PCORnet®, National Patient-Centered Clinical Research Network.
SUBJECTS: We studied women aged 18-55 years with delivery records from 2018 to 2019 (prepandemic), 2020-2021 (early pandemic), and 2022-2023 (late/postpandemic). Women with hypertension in pregnancy (HTN-PREG) were identified as those with documented hypertension 1 year prepregnancy or during pregnancy (40 wk predelivery).
MEASURES: We used the International Classification of Disease Clinical Modification/Procedure Classification codes, a normalized naming system for drug names (RXnorm), and the Current Procedural Terminology/Healthcare Common Procedure Coding System to identify deliveries, hypertension, and telehealth visits.
RESULTS: We examined 1,028,426 deliveries, of which 108,606 had HTN-PREG. The proportion of women with 1+ pregnancy telehealth use was higher in the early pandemic (15.8%) and late/postpandemic (16.4%) periods compared with prepandemic (0.2%). Telehealth use among HTN-PREG women was higher than among all women (0.24% prepandemic, 24.9% early pandemic, 26.8% late/postpandemic).. Among HTN-PREG women, telehealth use was lower among Hispanic women (19.2% and 23.2%) compared with NH Black (26.5% and 29.3%) or NH White (24.5% and 26.1%) women during the early and late/postpandemic periods, respectively. We observed similar patterns postpartum. All P values for comparisons were <0.001.
CONCLUSIONS: These findings underscore the value of aggregate PCORnet® data infrastructure and other standardized electronic health records in analyzing health care utilization trends and racial and ethnic differences among pregnant women.
RESEARCH DESIGN: We used a repeated cross-sectional design to assess aggregated and standardized electronic health records (EHR) from 28 participating US health systems in the PCORnet®, National Patient-Centered Clinical Research Network.
SUBJECTS: We studied women aged 18-55 years with delivery records from 2018 to 2019 (prepandemic), 2020-2021 (early pandemic), and 2022-2023 (late/postpandemic). Women with hypertension in pregnancy (HTN-PREG) were identified as those with documented hypertension 1 year prepregnancy or during pregnancy (40 wk predelivery).
MEASURES: We used the International Classification of Disease Clinical Modification/Procedure Classification codes, a normalized naming system for drug names (RXnorm), and the Current Procedural Terminology/Healthcare Common Procedure Coding System to identify deliveries, hypertension, and telehealth visits.
RESULTS: We examined 1,028,426 deliveries, of which 108,606 had HTN-PREG. The proportion of women with 1+ pregnancy telehealth use was higher in the early pandemic (15.8%) and late/postpandemic (16.4%) periods compared with prepandemic (0.2%). Telehealth use among HTN-PREG women was higher than among all women (0.24% prepandemic, 24.9% early pandemic, 26.8% late/postpandemic).. Among HTN-PREG women, telehealth use was lower among Hispanic women (19.2% and 23.2%) compared with NH Black (26.5% and 29.3%) or NH White (24.5% and 26.1%) women during the early and late/postpandemic periods, respectively. We observed similar patterns postpartum. All P values for comparisons were <0.001.
CONCLUSIONS: These findings underscore the value of aggregate PCORnet® data infrastructure and other standardized electronic health records in analyzing health care utilization trends and racial and ethnic differences among pregnant women.