Other Titles
Rising Star Poster/Presentation
Abstract
Background/Purpose: Our pregnancy healthcare work in Western New York (WNY) has revealed a pressing issue: high-risk patients are often forced to seek care outside their communities, leading to significant delays in addressing their medical and social needs. Our research, focusing on poor pregnancy outcomes in WNY rural areas, underscores the urgency. The challenges of limited resources and distance from healthcare facilities make it difficult for these individuals to receive adequate pregnancy care, resulting in gaps in health information due to fragmented care and disparate health information exchange databases.
Methods: To address this, we used the AHRQ CCSR to manually review ICD-10 codes that relate to pregnancy and its complications. We then applied these codes to data from HEALTHeLINK for 2022 and 2023 to test and refine our approach. After finalizing the definitions, we added data like county of residence and the National Area of Deprivation Index (ADI) to understand how access to care and health information exchange varies between urban and rural areas. We focused on four counties: Erie (urban), Genesee, Orleans, and Wyoming (rural).
Results: Our preliminary results showed differences in healthcare access and health outcomes between urban and rural pregnant people. Rural areas had higher deprivation indices, with ADI scores between 73.92 and 81.53, compared to 68.52 in Erie County. Pregnant people in rural areas had higher rates of diabetes and similar rates of hypertension, obesity, and mental health issues compared to those in urban areas. Most importantly, nearly half (49.4%) of pregnant people in rural areas had no outpatient visits over one year, compared to only 3.9% in urban areas. This is concerning since pregnant patients are recommended to have about 13 outpatient visits during an uncomplicated pregnancy. It is unclear whether these patients have had any prenatal care or there is a lack of communication between health information exchange databases.
Conclusions and Implications: This research supports past studies that show rural areas often have higher rates of chronic disease and fewer resources. The results highlight the struggles rural communities face, particularly with preexisting health conditions and access to outpatient care. With this information, healthcare providers can improve their care strategies and help improve communication between health systems.
Notes
References:
Agency for Healthcare Research and Quality (AHRQ). (2021). H-CUP Clinical Classifications Software Refined (CCSR). https://www.hcup-us.ahrq.gov/ toolssoftware/ccsr/ccs_refined.jsp.
Fontenot, J, Brigance, C., Ripley, R. & Stoneburner, A. (2024). Navigating geographical disparities: Access to obstetric hospitals in maternity care deserts and across the United States. BMC Pregnancy and Childbirth, 24, 350. https://doi.org/10.1186/s12884-024-06535-7
Government Accountability Office. (2022, October). Maternal health: Availability of hospital-based obstetric care in rural areas (Report to Congressional Committees). https://www.gao.gov/assets/gao-23-105515.pdf
Harrington, K. A., Cameron, N. A., Culler, K., Grobman, W. A., & Khan, S. S. (2023). Rural-Urban Disparities in Adverse Maternal Outcomes in the United States, 2016-2019. American journal of public health, 113(2), 224–227. https://doi.org/10.2105/AJPH.2022.307134
Kind, A.J.H, & Buckingham, W. (2018). Making neighborhood disadvantage metrics accessible: The neighborhood atlas. New England Journal of Medicine, 378, 2456-2458. https://www.nejm.org/doi/full/10.1056/NEJMp1802313
University of Wisconsin School of Medicine and Public Health. (2022) Area Deprivation Index v4.0.1. Downloaded from https://www.neighborhoodatlas.medicine.wisc.edu/ August 7, 2024.
Sigma Membership
Gamma Kappa, Pi Zeta
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Promoting Clinical Outcomes, Maternal Health, Pregnancy Care, Rural Areas, Western New York
Recommended Citation
Durfee, Stephanie Lynn and Hewner, Sharon, "Rural Maternal Health and Information Exchange Challenges in Western New York" (2025). Biennial Convention (CONV). 85.
https://www.sigmarepository.org/convention/2025/posters_2025/85
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Invited Presentation
Acquisition
Proxy-submission
Date of Issue
2025-12-09
Rural Maternal Health and Information Exchange Challenges in Western New York
Indianapolis, Indiana, USA
Background/Purpose: Our pregnancy healthcare work in Western New York (WNY) has revealed a pressing issue: high-risk patients are often forced to seek care outside their communities, leading to significant delays in addressing their medical and social needs. Our research, focusing on poor pregnancy outcomes in WNY rural areas, underscores the urgency. The challenges of limited resources and distance from healthcare facilities make it difficult for these individuals to receive adequate pregnancy care, resulting in gaps in health information due to fragmented care and disparate health information exchange databases.
Methods: To address this, we used the AHRQ CCSR to manually review ICD-10 codes that relate to pregnancy and its complications. We then applied these codes to data from HEALTHeLINK for 2022 and 2023 to test and refine our approach. After finalizing the definitions, we added data like county of residence and the National Area of Deprivation Index (ADI) to understand how access to care and health information exchange varies between urban and rural areas. We focused on four counties: Erie (urban), Genesee, Orleans, and Wyoming (rural).
Results: Our preliminary results showed differences in healthcare access and health outcomes between urban and rural pregnant people. Rural areas had higher deprivation indices, with ADI scores between 73.92 and 81.53, compared to 68.52 in Erie County. Pregnant people in rural areas had higher rates of diabetes and similar rates of hypertension, obesity, and mental health issues compared to those in urban areas. Most importantly, nearly half (49.4%) of pregnant people in rural areas had no outpatient visits over one year, compared to only 3.9% in urban areas. This is concerning since pregnant patients are recommended to have about 13 outpatient visits during an uncomplicated pregnancy. It is unclear whether these patients have had any prenatal care or there is a lack of communication between health information exchange databases.
Conclusions and Implications: This research supports past studies that show rural areas often have higher rates of chronic disease and fewer resources. The results highlight the struggles rural communities face, particularly with preexisting health conditions and access to outpatient care. With this information, healthcare providers can improve their care strategies and help improve communication between health systems.
Description
Participants will explore the impact of fragmented health information exchange on rural pregnancy outcomes in Western New York. This session will highlight disparities in access to perinatal care, the role of the Area Deprivation Index, and data-driven strategies to enhance communication between healthcare providers. Attendees will gain insight into improving care coordination for pregnant patients across urban and rural settings.