Women’s Health
Patterns of telehealth use during pregnancy and postpartum among commercially-insured women with live births, 2019—2021 Adit Doza* Adit Doza Lijing Ouyang Donatus U. Ekwueme Romeo R. Galang Brenda Bauman Lisa Romero Wanda Barfield Shanna Cox
Background: The use of telehealth has undergone a significant transformation in the aftermath of the COVID-19 pandemic. This study is designed to assess the shifts in telehealth utilization among pregnant and postpartum women from 2019 to 2021. It also aims to assess differences in telehealth use between rural and urban areas and describe the most frequently utilized services.
Methods: We used the Merative MarketScan Commercial database for women aged 15-49 who had a live birth delivery between 2019 and 2021, with continuous insurance enrollment for 10 months pre-delivery and 12 months post-delivery. We described patient characteristics stratified by telehealth user (TU) vs non-telehealth user (NTU) for all cohorts based on year of delivery. The major diagnostic categories (MDCs) were used to assess service types of telehealth use.
Results: The total telehealth visits during pre-delivery and post-partum periods were 60,655 in 2019; 204,935 in 2020; and 276,425 in 2021. An increasing proportion of telehealth visits occurred in the pre-delivery period (2.8% in 2019, 24.2% in 2020, and 46.1% in 2021). Across all cohorts, a higher proportion of TUs had diabetes (9.9%-12.8% vs. 6.2%-7.3%), hypertension (6.0-6.6% vs 3.7%-4.4%), and depression (6.4%-7.6% vs. 1.3-2.3%) compared to NTUs. Lower proportion of TUs lived in rural areas compared to NTUs (6.6%-7.3% vs 11.2%-13.0%). The MDC for mental health services was present for greater than 50% of telehealth visits during postpartum for all cohorts.
Conclusion: Increased telehealth visits among pregnant and postpartum women may relate to more accessible care or increased mental health needs. Further research may determine if increased telehealth use improves maternal and birth outcomes.