Trends in perinatal regionalization and the role of managed care

Détails

ID Serval
serval:BIB_9F70A19A8EAF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Trends in perinatal regionalization and the role of managed care
Périodique
Obstetrics and Gynecology
Auteur⸱e⸱s
Dobrez  D., Gerber  S., Budetti  P.
ISSN
0029-7844 (Print)
Statut éditorial
Publié
Date de publication
10/2006
Volume
108
Numéro
4
Pages
839-45
Notes
Journal Article
Research Support, N.I.H., Extramural --- Old month value: Oct
Résumé
OBJECTIVE: To describe trends in regionalization of perinatal care and identify factors that predict the extent of regionalization. METHODS: Data were drawn for four states for every year between 1989 and 1998. Panel data models estimated the effect of managed care enrollment on site of delivery for low, very low, and extremely low birth weight neonates. RESULTS: Strong evidence for regionalization over time was observed for North Carolina and Illinois, with little change in site of delivery in Washington. A shift from level III to level II hospitals was observed for low and very low birth weight neonates in California. Although managed care enrollment increased substantially in all four states, managed care had no effect on site of delivery; that is, the effect of managed care was near zero and not statistically significant in any state. CONCLUSION: Evidence supports the delivery of high-risk neonates at tertiary care centers. Despite changes in site of delivery, the percentages of very low birth weight neonates delivered at level III hospitals were substantially lower than the goal of 90% set by Healthy People 2010. Financial pressures introduced by managed care cannot be blamed for the failure to meet this goal. LEVEL OF EVIDENCE: II-2.
Mots-clé
Delivery, Obstetric/*trends Female Humans Infant, Low Birth Weight Infant, Newborn Managed Care Programs/*trends Perinatal Care/*trends Pregnancy *Pregnancy, High-Risk Regional Medical Programs/organization & administration/*trends Regression Analysis United States
Pubmed
Web of science
Création de la notice
25/01/2008 16:45
Dernière modification de la notice
20/08/2019 16:05
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