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Strengthening the evidence for maternal and child health programs

Find Established Evidence


Displaying records 1 through 5 (5 total).

Nugent RR. Perinatal regionalization in North Carolina, 1967-1979: services, programs, referral patterns, and perinatal mortality rate declines for very low birthweight infants. N C Med J. 1982;43(7):513-515.

Link: https://www.ncbi.nlm.nih.gov/pubmed/6956811

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Development/Improvement of Services, Continuing Education of Hospital Providers, Needs Assessment, POPULATION-BASED SYSTEMS, STATE, Policy/Guideline (State), Funding Support, Perinatal Committees/Councils, Increased Reimbursement

Intervention Results:

Among all VLBW infants, there was a change in birth location distribution. Of these infants, the percentage born in level III hospitals increased from 25.7% in period one to 46.8% in period four. The percentage born in level II hospitals decreased from 41.7% to 36% and the percentage born in level I also decreased from 32.6% to 17.2%. The authors do not comment on the statistical significance of these results.

Bowes WA, Jr. A review of perinatal mortality in Colorado, 1971 to 1978, and its relationship to the regionalization of perinatal services. Am J Obstet Gynecol. 1981;141(8):1045-1052.

Link: https://www.ncbi.nlm.nih.gov/pubmed/7315916

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, STATE, Policy/Guideline (State), Funding Support, Perinatal Committees/Councils

Intervention Results:

The proportion of VLBW births among total births in each hospital level shifted between the pretest and posttest period. In level III hospitals, the proportion of VLBW births among total births rose from 2.8% to 4.8% (p<0.05). In level II hospitals, the proportion of VLBW births among total births stayed the same (1.9%). In level I hospitals, there was a decrease from 1.6% to 1.1% of total births.

Hein HA, & Burmeister LF. The effect of ten years of regionalized perinatal health care in Iowa, U.S.A. Eur J Obstet Gynecol Reprod Biol. 1986;21(1):33-48.

Link: https://www.ncbi.nlm.nih.gov/pubmed/3956827

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Development/Improvement of Services, Continuing Education of Hospital Providers, Needs Assessment, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, Agreement for Level III Hospital to Accept All Patients, STATE, Funding Support, Perinatal Committees/Councils

Intervention Results:

  • The intervention in Iowa focused on increasing both level III and level II VLBW births due to population density concerns in Iowa.
  • Among all VLBW infants, there was a statistically significant change in the distribution of VLBW births (p<0.001). Of these infants, there was an increase in percentage born in level III hospitals from 6.7% to 35.3% and an increase in level II hospitals from 30.6% to 42.9%. The percentage born in level I centers decreased from 62.7% to 21.8%.

McCormick MC, Shapiro S, Starfield BH. The regionalization of perinatal services. Summary of the evaluation of a national demonstration program. JAMA. 1985;253(6):799-804.

Link: https://jamanetwork.com/journals/jama/fullarticle/396757

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Development/Improvement of Services, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, Consultation Systems, STATE, Policy/Guideline (State), Funding Support

Intervention Results:

  • Among all VLBW infants in intervention regions, there was a shift towards increasing births in tertiary centers from 35.72% in the pretest period to 47.3% at the time of intervention to 59.4% in the posttest period.
  • Among all VLBW infants in comparison regions, there was also a shift towards increasing births in tertiary centers from 29.67% in the pre-test period to 34.2% at the time of intervention to 47.19% in the posttest period.
  • The authors do not comment on the statistical significance of these results. However, the authors do note that the difference in the rate of centralization of births in tertiary centers was not “strikingly greater” in the intervention regions as compared with the comparison regions.

Nowakowski, L., Barfield, W. D., Kroelinger, C. D., Lauver, C. B., Lawler, M. H., White, V. A., & Ramos, L. R. (2012). Assessment of state measures of risk-appropriate care for very low birth weight infants and recommendations for enhancing regionalized state systems. Maternal and child health journal, 16(1), 217-227.

Link: https://doi.org/10.1007/s10995-010-0721-5

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): STATE, Policy/Guideline (State), Funding Support, POPULATION-BASED SYSTEMS, Telemedicine Systems, PATIENT/CONSUMER, Educational Material

Intervention Results:

Regulation of regionalization programs, data surveillance, review of adverse events, and consideration of geography and demographics were identified as mechanisms facilitating better measurement of risk-appropriate care. Antenatal or neonatal transfer arrangements, telemedicine networks, acquisition of funding, provision of financial incentives, and patient education comprised state actions for improving risk-appropriate care.
   

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.