Evaluation of a novel model for rural obstetric care. 2010

Eliseo Orrantia, and Heather Poole, and Jessica Strike, and Barbara Zelek
Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ont., USA. elisarah@shaw.ca

BACKGROUND The group practice physicians in Marathon, a small rural community in northwestern Ontario, discovered general lifestyle dissatisfaction with the traditional model for obstetric practice. The old model of doing the follow-up and delivery for one's own patients created perceived onerous on-call responsibilities. The providers created a new model of obstetric care. This involved the local providers of obstetric care each taking 1 month of the year in rotation and following up any woman due in that month for prenatal and intrapartum services. This study is an investigation of patient and provider satisfaction with this model. METHODS Patient survey: We surveyed all 73 women who received obstetric care under the new model during its first 14 months of implementation. We collected data on patient demographics and patients' satisfaction with their obstetric experience using Likert scale, yes/no and short-answer questions. Physician survey: We surveyed the 9 physicians of Marathon Family Practice using Likert scale, yes/no and short-answer questions. We collected information on demographics, history of involvement with obstetric service, and comparison of old and new models with regard to patient care, and professional and personal issues. RESULTS Patient survey: The response rate was 56%. Of the respondents, 97% reported their expectations for their obstetric care were met, if not surpassed, and 100% were satisfied with their obstetric care. Physician survey: All the physicians responded and found the new model to cause less disruption of their family practice (Wilcoxon signed rank test, p = 0.041), to improve scheduling of personal activities (p = 0.017) and to improve their satisfaction with on-call hours (p = 0.027). Overall, the physicians were satisfied with the new model and preferred it to the old model. CONCLUSIONS This obstetric care model meets patients' expectations and provides patient satisfaction. It provides practitioners with an increased quality of life and greater satisfaction. It is a viable paradigm for the provision of obstetric care in the appropriate setting.

UI MeSH Term Description Entries
D007588 Job Satisfaction Personal satisfaction relative to the work situation. Work Satisfaction,Job Satisfactions,Satisfaction, Job,Satisfaction, Work,Satisfactions, Job,Satisfactions, Work,Work Satisfactions
D008019 Life Style Typical way of life or manner of living characteristic of an individual or group. (From APA, Thesaurus of Psychological Index Terms, 8th ed) Lifestyle Factors,Life Style Induced Illness,Lifestyle,Factor, Lifestyle,Life Styles,Lifestyle Factor,Lifestyles
D009774 Obstetrics A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.
D009864 Ontario A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)
D010561 Personnel Staffing and Scheduling The selection, appointing, and scheduling of personnel. Staffing and Scheduling,Personnel Staffing,Work Schedule,Schedule, Work,Scheduling and Staffing,Staffing, Personnel,Work Schedules
D010821 Physicians, Family Those physicians who have completed the education requirements specified by the American Academy of Family Physicians. Family Physician,Family Physicians,Physician, Family
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003266 Continuity of Patient Care Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care. Continuum of Care,Continuity of Care,Care Continuity,Care Continuity, Patient,Care Continuum,Patient Care Continuity
D006123 Group Practice Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income. Group Practices,Practice, Group,Practices, Group

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