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Abstract：
BACKGROUND: To characterize the demographics of a modern hospitalized antepartum population, compare the morbidities of this subset to national morbidity trends, and identify predictors of satisfaction during hospitalization to inform opportunities to enhance equitable antepartum care.
METHODS: Pregnant people admitted to the antepartum service of a large university hospital between 2011 and 2019 were surveyed about their hospitalization, pregnancy outcomes, provider interactions, perceived needs, and resource use. Multiple correspondence analysis was used to group patient responses based on latent relationships among demographic, medical, and psychosocial variables. Multivariate analyses were conducted to identify predictors of patient experience rating. Patient free text responses were qualitatively analyzed for common themes.
RESULTS: Of 740 pregnant people invited to participate, 298 surveys met criteria for analysis. 25.2% of these pregnant people identified as non-white and 20.8% were admitted for the management of a chronic medical condition. Patient responses clustered into three representative groups: (1) working pregnant people facing resource limitations, (2) first-time pregnant people with college educations, and (3) pregnant people with medical problems and limited partner support. The mean overall patient admission experience rating was 8.4 ± 1.7 out of 10. Variables represented in Cluster 1 (working and resource limitations) were associated with lower patient experience rating (p < 0.01). There was no significant variation in experience rating with indication for admission (P = 0.14) or outcome of the pregnancy (P = 0.32). Conversely, feeling supported by partners (P < 0.01) and providers (P < 0.01) directly correlated with a better experience.
CONCLUSIONS: Black pregnant people and those with chronic medical conditions are overrepresented in this antepartum population when compared to the demographics of those not requiring hospitalization in pregnancy, where these groups also have higher rates of maternal morbidity and mortality at the national level. The most important contributors to patients\' satisfaction with their antepartum experience are feeling listened to by providers and supported by partners. Improving patient-provider communication and partner engagement during antepartum admissions should be a focus of inpatient high-risk obstetric care.
METHODS: Pregnant people admitted to the antepartum service of a large university hospital between 2011 and 2019 were surveyed about their hospitalization, pregnancy outcomes, provider interactions, perceived needs, and resource use. Multiple correspondence analysis was used to group patient responses based on latent relationships among demographic, medical, and psychosocial variables. Multivariate analyses were conducted to identify predictors of patient experience rating. Patient free text responses were qualitatively analyzed for common themes.
RESULTS: Of 740 pregnant people invited to participate, 298 surveys met criteria for analysis. 25.2% of these pregnant people identified as non-white and 20.8% were admitted for the management of a chronic medical condition. Patient responses clustered into three representative groups: (1) working pregnant people facing resource limitations, (2) first-time pregnant people with college educations, and (3) pregnant people with medical problems and limited partner support. The mean overall patient admission experience rating was 8.4 ± 1.7 out of 10. Variables represented in Cluster 1 (working and resource limitations) were associated with lower patient experience rating (p < 0.01). There was no significant variation in experience rating with indication for admission (P = 0.14) or outcome of the pregnancy (P = 0.32). Conversely, feeling supported by partners (P < 0.01) and providers (P < 0.01) directly correlated with a better experience.
CONCLUSIONS: Black pregnant people and those with chronic medical conditions are overrepresented in this antepartum population when compared to the demographics of those not requiring hospitalization in pregnancy, where these groups also have higher rates of maternal morbidity and mortality at the national level. The most important contributors to patients\' satisfaction with their antepartum experience are feeling listened to by providers and supported by partners. Improving patient-provider communication and partner engagement during antepartum admissions should be a focus of inpatient high-risk obstetric care.
摘要：
背景：为了表征现代住院产前人群的人口统计学特征，将这一子集的发病率与国家发病率趋势进行比较，并确定住院期间满意度的预测因素，为加强公平的产前护理提供机会。
方法：对2011年至2019年接受大型大学医院产前服务的孕妇进行住院情况调查，妊娠结局,提供者交互，感知需求，和资源使用。多重对应分析用于根据人口统计学、medical,和心理社会变量。进行多变量分析以确定患者体验评分的预测因子。对患者的自由文本回答进行了共同主题的定性分析。
结果：在被邀请参加的740名孕妇中，298项调查符合分析标准。这些孕妇中有25.2％被确定为非白人，而20.8％的人因治疗慢性疾病而入院。患者的反应分为三个代表组：（1）面临资源限制的工作孕妇，(2)受过大学教育的首次怀孕者，（3）有医疗问题和有限伴侣支持的孕妇。平均总体患者入院经历评分为8.4±1.7，满分10分。第1组中的变量（工作和资源限制）与较低的患者体验等级相关（p<0.01）。经验评分与入院指征（P=0.14）或妊娠结局（P=0.32）没有显着差异。相反，伴侣（P<0.01）和提供者（P<0.01）的支持感与更好的体验直接相关。
结论：与怀孕期间不需要住院的人口统计学相比，黑人孕妇和患有慢性疾病的人在该产前人群中的比例过高，在国家一级，这些群体的孕产妇发病率和死亡率也较高。患者对产前体验满意的最重要因素是提供者的倾听和合作伙伴的支持。在产前入院期间改善患者与提供者的沟通和合作伙伴的参与应成为住院高危产科护理的重点。
方法：对2011年至2019年接受大型大学医院产前服务的孕妇进行住院情况调查，妊娠结局,提供者交互，感知需求，和资源使用。多重对应分析用于根据人口统计学、medical,和心理社会变量。进行多变量分析以确定患者体验评分的预测因子。对患者的自由文本回答进行了共同主题的定性分析。
结果：在被邀请参加的740名孕妇中，298项调查符合分析标准。这些孕妇中有25.2％被确定为非白人，而20.8％的人因治疗慢性疾病而入院。患者的反应分为三个代表组：（1）面临资源限制的工作孕妇，(2)受过大学教育的首次怀孕者，（3）有医疗问题和有限伴侣支持的孕妇。平均总体患者入院经历评分为8.4±1.7，满分10分。第1组中的变量（工作和资源限制）与较低的患者体验等级相关（p<0.01）。经验评分与入院指征（P=0.14）或妊娠结局（P=0.32）没有显着差异。相反，伴侣（P<0.01）和提供者（P<0.01）的支持感与更好的体验直接相关。
结论：与怀孕期间不需要住院的人口统计学相比，黑人孕妇和患有慢性疾病的人在该产前人群中的比例过高，在国家一级，这些群体的孕产妇发病率和死亡率也较高。患者对产前体验满意的最重要因素是提供者的倾听和合作伙伴的支持。在产前入院期间改善患者与提供者的沟通和合作伙伴的参与应成为住院高危产科护理的重点。
