Evolving trends in maternal fetal medicine referrals in a rural state using telemedicine.

摘要

To determine maternal fetal medicine (MFM) referral trends in a Medicaid population over time.Sixteen clinical guidelines and 23 clinical conditions were identified where co-management/consultation with MFM specialist is recommended. Linked Medicaid claims and birth certificate data for 2001-2006 were used to identify pregnancies with these conditions and whether they received co-management/consultation from a MFM specialist.Between 2001 and 2006, there were 108,703 pregnancies with delivery of 110,890 neonates. Forty-five percent had one or more of the conditions identified for co-management/consultation. Overall pregnancies receiving MFM contact remained unchanged at 22.2?% in 2001 and 22.1?% in 2006. However, face to face contacts decreased from 14.6?% (2001) to 8.7?% (2006) while telemedicine consults increased from 7.6?% (2001) to 13.3?% (2006). Health departments were most likely and family practitioners least likely to refer to MFM (p?