Research

The project: Access to prenatal and newborn care are critical components to improve birth outcomes and reduce infant deaths. Despite Medicaid expansion, many families in Michigan lack health insurance and access to care. Such families often face overwhelming barriers to care including limited or no transportation, poverty, child care, competing demands, and work schedules.

Since 2016, the Luke Clinic in Detroit has provided twice-monthly free care for prenatal and postpartum mothers and their infants through one year of life. In 2020 the Luke Clinic piloted the Mobile Antenatal Testing Unit (MATU), providing community/home-based care to families with high-risk pregnancies and social barriers to care. When the COVID-19 pandemic hit, the MATU became a bridge to care for many families for whom it is unsafe to attend clinic appointments or who need hands-on testing in combination with virtual medical care. This project supports the evaluation of the MATU project to provide the basis for future improvements and quality care.

The process:

1. Cost-benefit analysis: The research team collated and analyzed all parts of care provided on the mobile clinic and converted these to costs and benefits to look at overall cost-effectiveness. This included both direct costs and benefits as well as indirect health and societal costs. The results suggest strong favorable economic benefits from mobile care.
2. Patient survey:  As part of the study, the researchers conducted a quantitative year-long survey in English, Spanish, and Arabic to assess social determinants of health for patients, clinic satisfaction, and barriers to care.
3. Qualitative interviews: An adjunct qualitative project was developed in association with this project to look at the experiences of Black women at this free, faith-based clinic.  

Results: Patient satisfaction results and recommendations for improvement were shared with the Luke Clinic staff and board of directors and have helped focus efforts on improving satisfaction and quality at the clinic.  Quantitative data from the study is being used to develop subsequent grant applications and to identify cost-effective aspects of care.  

The researchers have authored two journal articles based on the findings, and publication is pending.

Katherine Gold, U-M Departments of Family Medicine and Obstetrics & Gynecology
David Hutton, School of Public Health at U-M
Penny Armbruster, executive director of Luke Clinic