(1103) Prenatal Mobile Self-Operated Home Ultrasound Service Impact on Heath Care Resources Utilization

Mobile medical devices for self-patient use are rapidly evolving. A leading HMO (Clalit Health Services, Israel) launched a home-ultrasound (Pulsenmore Ltd.) service enabling a basic sonographic assessment interpreted by a clinician via asynchronous teleconsultation.
We aimed to examine whether the use of the device and its adjunct medical service can provide financial benefits for both patients and the healthcare system

Study Design: Retrospective cohort between 2021 and 2023, comparing 4,460 women using Clalit’s home ultrasound service with a control group of 102,707 women with an equal HMO status, who did not obtain this service. Demographic characteristics, number (№) of emergency room (ER) visits, № of hospitalizations, № of hospital stay days and № of OBGYN primary caregiver visits were compared between the groups as well as composite outcome of these variables

Results: Women in the study group were older, more likely primiparous, had higher incidence of chronic illness, more often considered to be at high-risk pregnancy and had higher socio-economic score in comparison to controls (Table 1). Univariate analysis demonstrated lower rates of ER visits, hospitalizations and in-hospital days in favor of the study group (p< 0.0001). № of OBGYN primary caregiver visits were higher among the study group (p< 0.0001), however it embodies administrative and phone call appointments, making it difficult to estimate the exact in-person visits. Furthermore, higher rates of chronic illnesses and high-risk pregnancies likely requires closer surveillance. In a multivariate analysis for age, BMI, parity, socioeconomic score, and chronic illness the calculated adjusted value of ER visits, № of hospitalization, № of in-hospital days and a composite score of ER visits and in-hospital days were all lower in the study group compared to controls (2.24 vs 2.38, p=0.0268; 0.34 vs 1.53, p< 0.0001; 0.95 vs 4.75, p< 0.0001 and 3.17 vs 7.6, p< 0.0001) 

Conclusion: Prenatal mobile self-operated home ultrasound service may ease the burden of healthcare resource utilization, mainly emergency visit and in-hospital stay