The relation of obstetrical volume and nursery level to perinatal mortality

We investigated the relation of hospital delivery volume and nursery technology level to perinatal outcome in 226,164 White singleton births in Washington State, 1980-83. Level III facilities (neonatal intensive care unit) were defined by the state licensing commission. We defined the Level II (intermediate) and Level I (normal newborn) facilities using published criteria. Infants under 2000 gm born in Level III facilities had half the risk of perinatal death compared to those born in a Level I or II facility. No significant improvement was noted among level or volume groupings for normal birthweight infants. A loglinear regression model of hospital perinatal death rates showed that when birthweight and maternal risk were controlled, obstetrical volume added minimal explanatory power to level of nursery care

Environmental health · Infant mortality · Intensive care · Intensive care medicine · Neonatal intensive care unit · Obstetrics · Population · Pregnancy · Singleton · Demography · Food Security and Health in Diverse Populations · Global Maternal and Child Health · Healthcare Policy and Management · Medicine · Pediatrics

• Effectiveness of Health Care Services for Pregnant Women and Infants

  Andrew D Racine, Thomas Joyce et al.•The Future of Children•1992

  Incluir item

• Physician Volume and Obstetric Outcome

  Michael Lefevre, Michael L Lefevre•Medical Care•1992

  Incluir item

• Comparing Hospital Perinatal Mortality Rates

  BRUNO HOLTHOF, PETER PRINS•Medical Care•1993

  Incluir item

• Use of High-Technology Care Among Women with High-Risk Pregnancies in the United States

  Open Access•Rachel M Schwartz, Janet H Muri et al.•Maternal and Child Health Journal•2000

  Incluir item

• A New Method to Examine Very Low Birth Weight Fetal and Hebdomadal Mortality in a Regionalized System of Perinatal Care

  Open Access•Thomas C Hulsey, Tara F McComb et al.•Maternal and Child Health Journal•1998

  Incluir item

• Maternal Complications of Normal Deliveries

  Open Access•Paige E Heaphy, Shulamit Bernard et al.•The Journal of Rural Health•2000

  Incluir item

• Providing Birthing Services in Rural Health Networks

  Open Access•Thomas C Rosenthal, Elysa Ferrara et al.•The Journal of Rural Health•1996

  Incluir item

• Technology at birth

  Nigel Paneth•American Journal of Public Health•1990

  Incluir item

• Deregionalization of Neonatal Intensive Care in Urban Areas

  Embry M Howell, Embry Howell et al.•American Journal of Public Health•2002

  Incluir item

• Maternal transfers and hospital perinatal mortality rates

  Bruce Fireman, B H Fireman et al.•American Journal of Public Health•1991

  Incluir item

• Mayfield Responds

  Jennifer Mayfield, Jennifer A Mayfield•American Journal of Public Health•1991

  Incluir item

• Characteristics of infant deaths due to HIV/Aids

  Susan Y Chu, James W Buehler et al.•American Journal of Public Health•1991

  Incluir item

• The regionalization of perinatal care in Wales and Washington State

  Roger A Rosenblatt, A Macfarlane et al.•American Journal of Public Health•1996

  Incluir item

• The Effect of Neonatal Intensive Care Level and Hospital Volume on Mortality of Very Low Birth Weight Infants

  Judith H Chung, Ciaran S Phibbs et al.•Medical Care•2010

  Incluir item

• Evaluating the Effect of Hospital and Insurance Type on the Risk of 1-year Mortality of Very Low Birth Weight Infants

  Songthip Ounpraseuth, C Heath Gauss et al.•Medical Care•2012

  Incluir item

• Estrutura das maternidades

  Open Access•Sônia Azevedo Bittencourt, Sonia Duarte De Azevedo Bittencourt et al.•Cadernos de Saude Publica•2014

  Incluir item

• Impact of maternity unit closures on access to obstetrical care

  Open Access•Hugo Pilkington, Béatrice Blondel et al.•Social Science & Medicine•2008

  Incluir item

• Should Operations Be Regionalized?

  Harold S Luft, John P Bunker et al.•New England Journal of Medicine•1979

  Incluir item

• Access to obstetric care in rural areas

  Thomas S Nesbitt, F A Connell et al.•American Journal of Public Health•1990

  Incluir item

• A comparative study of hospital fetal death records and Washington State fetal death certificates

  L Harter, L P Harter et al.•American Journal of Public Health•1986

  Incluir item

• Does Practice Make Perfect

  Ann Barry Flood, W Richard Scott et al.•Medical Care•1984

  Incluir item

• Does Practice Make Perfect

  Ann Barry Flood, W Richard Scott et al.•Medical Care•1984

  Incluir item

• Selecting Categories of Patients for Regionalization

  Susan C Maerki, Susan Maerki et al.•Medical Care•1986

  Incluir item

• Assessing the Effectiveness of Neonatal Intensive Care

  Peter P Budetti, Peggy McManus•Medical Care•1982

  Incluir item

• Measuring the Effectiveness of Perinatal Medical Care

  Ronald L Williams•Medical Care•1979

  Incluir item