Postpartum implications of screening for social determinants of health at the time of delivery

OBJECTIVES: The Illinois Perinatal Quality Collaborative (ILPQC) aims to enhance perinatal care in Illinois. However, up to 50% of women do not attend postpartum care. This study assessed the impact of universal screening for social determinants of health (SDoH) during labor and delivery on postpartum care attendance. 

METHODS: A retrospective chart review was conducted for women who delivered at a large academic medical center. The study received exempt status from Loyola University Institutional Review Board. Universal SDoH screening was implemented in March 2022. Data were collected from a control group (six months pre-implementation) and an intervention group (six months post-implementation). The primary outcome was attendance at both scheduled postpartum visits. Comparisons were made using Pearson chi-square for categorical variables and ANOVA for continuous variables. Finally, a multinomial regression model, adjusted for patient characteristics, was used to estimate the effect of universal screening on postpartum appointment attendance. Significance was set at p < .05. 

RESULTS: The sample included 1,098 women, with 541 in the control group and 557 in the intervention group. The SDoH screening completion rate was 75.0% (n = 415). Basic demographics were similar, with minor differences addressed in regression models. Women in the intervention group were 1.69 times more likely to attend both postpartum visits (RRR = 1.69, 95% CI [1.14, 2.51], p = .009) compared to those in the control group. 

CONCLUSIONS: Implementing SDoH screening at our hospital improved postpartum visit attendance.