Maternal and Child Health Journal

, Volume 16, Issue 1, pp 217–227

Assessment of State Measures of Risk-Appropriate Care for Very Low Birth Weight Infants and Recommendations for Enhancing Regionalized State Systems

  • Lindsey Nowakowski
  • Wanda D. Barfield
  • Charlan D. Kroelinger
  • Cassie B. Lauver
  • Michele H. Lawler
  • Vanessa A. White
  • Lauren Raskin Ramos
Article

DOI: 10.1007/s10995-010-0721-5

Cite this article as:
Nowakowski, L., Barfield, W.D., Kroelinger, C.D. et al. Matern Child Health J (2012) 16: 217. doi:10.1007/s10995-010-0721-5

Abstract

The goal of this study was to examine state measurements and improvements in risk-appropriate care for very low birth weight (VLBW) infants. The authors reviewed state perinatal regionalization models and levels of care to compare varying definitions between states and assess mechanisms of measurement and areas for improvement. Seven states that presented at a 2009 Association of Maternal & Child Health Programs Perinatal Regionalization Meeting were included in the assessment. Information was gathered from meeting presentations, presenters, state representatives, and state websites. Comparison of state levels of care and forms of regulation were outlined. Review of state models revealed variability in the models themselves, as well as the various mechanisms for measuring and improving risk-appropriate care. 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. The void of explicit and updated national standards led to the current variations in definitions and models among states. State regionalization models and measures of risk-appropriate care varied greatly. These variations arose from inconsistent definitions and models of perinatal regionalization. Guidelines should be collaboratively developed by healthcare providers and public health officials for consistent and suitable measures of perinatal risk-appropriate care.

Keywords

Perinatal regionalizationRisk-appropriate careVery low birth weight infantsNeonatal levels of care

Copyright information

© Springer Science+Business Media, LLC (outside the USA)  2010

Authors and Affiliations

  • Lindsey Nowakowski
    • 1
  • Wanda D. Barfield
    • 2
  • Charlan D. Kroelinger
    • 2
  • Cassie B. Lauver
    • 3
  • Michele H. Lawler
    • 3
  • Vanessa A. White
    • 4
  • Lauren Raskin Ramos
    • 4
  1. 1.Medical College of Georgia, School of MedicineAugustaUSA
  2. 2.Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaUSA
  3. 3.U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health BureauRockvilleUSA
  4. 4.Association of Maternal & Child Health ProgramsWashingtonUSA