Study to Gauge Priorities of Pregnant Women

A Cedars-Sinai physician-researcher has been approved for a two-year, $699,980 funding award by the Patient-Centered Outcomes Research Institute (PCORI) to study the expressed healthcare priorities of pregnant women. The study was among 46 proposals that PCORI recently approved for funding to advance the field of comparative clinical effectiveness.

Kimberly D. Gregory, MD, MPH

Kimberly D. Gregory, MD, MPH, maternal-fetal medicine specialist and vice chair for Women's Healthcare Quality and Performance Improvement in the Department of Obstetrics and Gynecology, is the lead Cedars Sinai principal investigator for the research project. With the aid of focus groups and a national survey, the study seeks to produce a framework for measuring childbirth patient-reported outcomes that are priorities for women.

Childbirth is the No. 1 cause for hospital admission in the U.S., with combined mother-and-baby charges totaling $98 billion according to PCORI’s project summary. Despite that enormous footprint on the nation’s healthcare system, a framework for evaluating the childbirth experience from the mother’s standpoint remains largely undeveloped, the researchers say. The main issue is the lack of a conceptual foundation for how women prioritize their perceived needs and service preferences. Gregory hopes her study will provide that foundation.

"Results from this project could be used to generate patient-reported outcomes that hospitals use to determine patient satisfaction and that payers use to determine quality, value and perhaps even reimbursement," said Gregory, who also is a professor of Obstetrics and Gynecology.

The project is an outgrowth of research that Gregory has been conducting for more than 15 years to develop quality indicators for maternity care and learn more about maternal outcomes and safety. Her collaborators in this effort include: co-principal investigator Lisa M. Korst, MD, PhD, owner of Childbirth Research Associates LLC in Los Angeles; statistician Moshe Fridman, PhD, owner of AMF Consulting in Los Angeles; and Samia El Haj Ibrahim, MPH, clinical research specialist and study coordinator at Cedars-Sinai.

For the PCORI study, the researchers plan to partner with providers of pregnancy and childbirth services, advocacy groups, public health leaders, recently pregnant women and other community partners to organize focus groups. Based on the findings of these groups, they plan to work with Harris Interactive to conduct a national, online survey of 1,200 women regarding their priorities for services and outcomes for childbirth. These expressed priorities will be compared among various communities, including racial and ethnic groups, educational levels and women with or without previous childbirth experience. Guidelines for survey instruments will then be drafted to reflect those priorities.

The Patient-Centered Outcomes Research Institute is an independent, nonprofit organization authorized by Congress in 2010 to fund comparative clinical effectiveness research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health and healthcare decisions. Since 2012, it has approved $671 million to support 360 research studies and initiatives. The review process is highly competitive. The 46 projects most recently approved for funding were chosen from 490 applications.