Article Document Academic Article Information Content Entity Continuant Continuant Journal Article Entity Entity Generically Dependent Continuant 2025-05-07T10:25:42 RDF description of Ambulatory care utilization in the first 24 months' postpartum by rurality and pregnancy-related conditions: a prospective cohort study from Maine - http://repository.healthpartners.com/individual/document-rn38308 Pregnancy <p>PURPOSE: To estimate the rate of ambulatory care use among postpartum persons by rurality of residence and pregnancy-related conditions. <br>METHODS: We used Maine Health Data Organization's All Payer Claims Data for persons who delivered between 2007 and 2019 (N = 121,905). We estimated rates of ambulatory care (nonemergency department outpatient health care) utilization during the first 24 months' postpartum by level of rurality (urban, large rural, small rural, and isolated rural) and by pregnancy-related conditions (prenatal depression, hypertensive disorders of pregnancy, and gestational diabetes). To estimate rate ratios (RR), we used Poisson regression with an offset for population at risk, adjusting for potential confounders and restricting the analysis to those with continuous insurance (n = 70,431). <br>FINDINGS: The mean monthly rate per 100 deliveries of ambulatory care visits was 86.1; the median number of visits was 12 (interquartile range = 6, 25). Persons living in rural areas had lower monthly rates of visits than persons living in urban areas (adjusted RR ranged from 0.87 [95% CI: 0.85, 0.89] in isolated rural areas to 0.91 [95% CI: 0.90, 0.93] in large rural areas). Persons with prenatal depression (aRR = 2.07; 95% CI: 2.04, 2.11), hypertensive disorders of pregnancy (aRR = 1.07; 95% CI: 1.05, 1.10), and gestational diabetes (aRR = 1.11; 95% CI: 1.08, 1.14) had higher rates of visits than those without these conditions. <br>CONCLUSIONS: New practices and policies may be needed to improve postpartum ambulatory care access and utilization in rural areas. Postpartum persons with pregnancy-related conditions are accessing ambulatory care at higher rates after delivery, which may reduce their need for acute health care use.<p> 10.1111/jrh.12912 40872 Cohort Studies 41 Postpartum Period Ambulatory care utilization in the first 24 months' postpartum by rurality and pregnancy-related conditions: a prospective cohort study from Maine Prospective Studies Quality of Health Care public 1 document-rn38308 Utilization 23616 2024-12-31T17:58:18.897-06:00 Journal of Rural Health Rural Health