Covid-19 Pandemic: Impact On Obstetric Services And Outcomes: A Retrospective Study

Background During COVID-19 crisis, the provision of healthcare appears to be in the middle of an imposed, rather unavoidable digital revolution. Since most clinical workflows and health care delivery systems are designed around an in-person or face-to-face model of care, the impact of telemedicine practices on either patient or physician is less known. Aim To inform the post-pandemic obstetric care, we sought to explore the perceptions of the new virtual care model by patients and physicians. Design Cross-sectional survey of the patients attending the prenatal clinic during the start of the pandemic (March 2020- July 2020) and the physicians providing the same care. The investigators gathered 53 patient-satisfaction and 14 physician-satisfaction questionnaires. Scores were compared between the traditional model and virtual-care model for patient satisfaction surveys. Factors associated with higher satisfaction were assessed. Results Mean patient satisfaction scores were significantly higher with regular visits compared to virtual visits (4.56 versus 4.43, P 0.023). This difference was more pronounced in women with previous poor obstetric outcomes. While women found their physicians to be friendlier on virtual visits, traditional visits had allowed easier scheduling. Differences in age, ethnicity, distance to travel and working status did not lessen the satisfaction. Overall, physicians reported a mean score of 65.5 for a maximum of 100. Clinicians with prior experience and 'frequent' use of telehealth services were more likely to be satisfied than others. Conclusion Mothers were less satisfied with virtual prenatal care compared to traditional visits. Telehealth services, especially in vulnerable patient populations, are likely suboptimal in achieving patient satisfaction. Practical Implications Emphasis should be laid on the ease of scheduling visits, and special considerations should be made for women with previous poor obstetric outcomes.