Evaluating impact of population health outreach and an interdepartmental approach to perinatal depression

OBJECTIVE: Evaluate the impact of connecting obstetrics with psychiatry in addressing prenatal depression. We compared patient engagement with behavioral health, prescriptions and follow-up over time after implementation of a population health central team outreach to depressed pregnant persons in 2019. Behavioral health joined the EHR facilitating collaboration in 2020. METHODS: In a cohort of deliveries across 8 hospitals from 1/1/2021-12/31/2024, we studied patients who screened positive for depression prenatally. OUTCOMES: 1. Documentation of behavioral health visit while pregnant or within 1 year postpartum, 2. Antidepressant prescription while pregnant or within 1 year postpartum, and 3. Compliance with Pennsylvania's Medicaid obstetric reimbursement bundle quality metric for depression follow-up within 30 days of positive screen. Secondary analyses explored collaboration by limiting to targeted behavioral health departments and explored impact of telemedicine. RESULTS: Of 54,483 deliveries, 48,238 (89 %) were administered the PHQ-2/9, 5139 screened positive and 3732 had 1-year postpartum follow-up. As collaboration efforts increased and the population health team expanded, we observed a linear increase in engagement with behavioral health and adherence with depression follow-up. Depressed pregnant persons delivering in 2023 were 50 % more likely to have a behavioral health visit (adjOR 1.54; 95 % CI: 1.25, 1.91) and 40 % more likely to have follow-up (adjOR 1.41, 95 % CI: 1.21, 1.65) compared with persons delivering in 2021. These trends were stronger when limiting to collaborative behavioral health departments. CONCLUSION: A cross-disciplinary care model facilitated by centralized population health team is an impactful approach to connect depressed pregnant persons with appropriate care. 2890/4000; /4 tables or figures. PRECIS: A cross-discipline approach facilitated by a population health team increased behavioral health engagement for patients with perinatal depression.