Renée Betancourt, MD

Evaluation of an Academic-community Clinical Partnership to Increase Access to Prenatal, Postpartum, and Gynecologic Services in West Philadelphia

Principal Investigator: Renée Betancourt, MD | Perelman School of Medicine

This project will evaluate a newly formed partnership in which the University of Pennsylvania Department of Family Medicine and Community Health clinicians deliver prenatal, postpartum, and other gynecologic services at local a community-based site of care for patients who are pregnant. Prenatal patients receiving care will be directed to receive their acute triage and labor and delivery care at the Hospital of the University of Pennsylvania on the Family Medicine Obstetrical Service. The evaluation will involve a case-control matched comparison of patients who receive care in this new model compared with control patients who received prenatal care in the five years leading up to the start of this partnership. The team will assess important delivery and neonatal variables that constitute significant areas of neonatal and birthing racial disparities such as gestational age at delivery, severe pre-eclampsia, estimated blood loss, neonatal transfer to the intensive care nursery, and infant birth weight. The goal is to determine the impact of this relationship on the clinical care of this patient population and will inform future efforts to establish and continue other such partnerships.

Rachel Kelz, MD, MSCE

Using Data to Achieve Surgical Equity in the Community

Principal Investigator: Rachel Kelz, MD, MSCE | Perelman School of Medicine

Gallbladder disease (GBD) is extremely common, affecting 10% to 20% of adults in the United States with a prevalence as high as 70% in specific ethnic groups. Delayed treatment often leads to emergency surgery. Emergent cholecystectomy results in increased morbidity, mortality, length of stay, and higher costs when compared to elective cholecystectomy. Black and Hispanic patients, non-English primary language speakers, and those living in areas of greater social vulnerability are at increased risk of emergent gallbladder surgery. Black patients with established primary care providers within the Penn Medicine Primary Care Service Line are more likely to undergo emergent (versus elective) cholecystectomy than White patients. To address this disparity, we will examine racial disparities of patients with symptomatic GBD with attention to conditional effects of social vulnerabilities, and compare the effectiveness of telemedicine consultation for symptomatic GBD in patients with social vulnerabilities to usual care. The results will provide data to develop evidence-based solutions to disparities within Penn Medicine and serve as preliminary data for a subsequent R01 or PCORI grant to address surgical disparities in patients with symptomatic GBD.