Prenatal Care Capacity Assessment in Philadelphia

Philadelphia has one of the highest rates of infant mortality in the nation. With the closure of 13 obstetric (OB) inpatient units since 1997, the question arises if there is sufficient prenatal care capacity in Philadelphia at this time. The objectives of this study are to: 1) determine the number of prenatal care slots available in Philadelphia; 2) determine the full-time work equivalent of providers offering prenatal care; 3) identify the available hours for prenatal care 4) determine types of insurance and/or payment methods; 5) identify the average length of time a newly pregnant woman has to wait for an initial appointment; and 6) identify how prenatal care capacity has changed in the past 5-10 years. Quantitative surveys were e-mailed and faxed to identified sites and qualitative interviews were conducted with four key personnel. Completed surveys were received from 20 sites. The calculated FTE for a total of 90 providers was 19.8 providers, which represents a workforce of only 22% of the possible 100%. The majority of available hours were reported between 8AM and 5PM, Monday-Friday, with 10% of sites providing hours before 8AM and 25% of sites providing hours after 5PM. All sites reported accepting private insurance and medical assistance. Additionally, the average wait time for a prenatal care appointment was reported to be 10.26 days. Qualitative findings were consistent with the literature. Prenatal care hours need to be expanded and the provider work-force needs to be increased. Furthermore, political and economical barriers to providing the critical support services need to be addressed and implementation of an annual city-wide surveillance for prenatal care capacity is necessary.