PATIENT OUTCOMES WITH EARLY PREGNANCY COMPLICATIONS AFTER EXPOSURE TO AN EARLY PREGNANCY ASSESSMENT CLINIC

Abstract

Objectives

We aimed to evaluate the healthcare burden experienced by patients with early pregnancy complications seen in an early pregnancy assessment clinic (EPAC) and those never seen in an EPAC.

Methods

We performed a retrospective cohort study evaluating patients 18 years and older who presented during the first 12 weeks of pregnancy with a complication including vaginal bleeding or pain, early pregnancy loss (EPL), pregnancy of unknown location (PUL), ectopic, or molar pregnancy. The primary outcome was the healthcare burden for patients seen in an EPAC compared to patients never seen in an EPAC. Healthcare burden was defined as the total number of encounters and the average time spent in the healthcare system.

Results

We obtained data from 241 patients between January 2021 and June 2022. Patients never seen in EPAC were more likely to be of Hispanic ethnicity (52% vs 30%, p<0.001), have public or no insurance (59% vs 25%, p<0.001), and report a non-English primary language (33% vs 10%, p<0.001) compared with patients seen in an EPAC. The median (range) total number of healthcare encounters was 4 (2, 5.5) and 3 (2,5) in the EPAC and non-EPAC groups, respectively (p=0.3). The mean in-person healthcare encounter time (hours) was significantly higher in the non-EPAC group (327 vs 120, p<0.001).

Conclusions

Patients never seen in an EPAC were more likely to have socioeconomic and language barriers compared to those seen in an EPAC. Increasing access to expedited evaluation and management of early pregnancy complications may improve patients’ healthcare experience.