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Differential Markers for Regionalization

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Abstract

OBJECTIVE:

To examine the site of delivery for very low birth weight (VLBW) infants and infants with major congenital malformations (MCM) within an established system of perinatal regionalization.

STUDY DESIGN:

A retrospective study of site of delivery for VLBW infants and infants born with MCM (tracheoesophageal fistula/esophageal atresia, diaphragmatic hernia, or gastroschisis/omphalocele) from 1990 through 1995 in Ohio.

RESULTS:

A total of 59.8% of VLBW infants and 36.1% of MCM infants were born in a level III hospital. There was a significant trend toward a decrease in VLBW infants (p < 0.01) and an increase in MCM infants (p < 0.05) born in a level III hospital between 1990 and 1995. There were significant regional variations among the six perinatal regions in Ohio in the proportion of both VLBW and MCM infants born in a tertiary center.

CONCLUSION: Using the traditional marker of VLBW to assess regionalization in one state, we found significant variation in site of delivery among the perinatal regions and over the time course of the study. The delivery of infants with MCM at level III centers may be an alternative measure of regionalization.

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Authors and Affiliations

  1. Division of Health Policy and Clinical Effectiveness (S. M., H. D. A., P. J. S., P. H. P., U. R. K.), Cincinnati, OH

    Sanjeev Mehta BA, Harry D Atherton BSE E MS, Pamela J Schoettker MS, Paul H Perlstein MD & Uma R Kotagal MBBS MSc

  2. Division of Neonatology (P. H. P., Department of Pediatrics, U. R. K.), Children’s Hospital Medical Center, Cincinnati, OH

    Paul H Perlstein MD & Uma R Kotagal MBBS MSc

  3. Institute of Health Policy and Health Services Research (R. W. H., U. R. K.), University of Cincinnati, Cincinnati, OH

    Richard W Hornung DrPH & Uma R Kotagal MBBS MSc

Authors
  1. Sanjeev Mehta BA
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  2. Harry D Atherton BSE E MS
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  3. Pamela J Schoettker MS
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  4. Richard W Hornung DrPH
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  5. Paul H Perlstein MD
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  6. Uma R Kotagal MBBS MSc
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Corresponding author

Correspondence to Uma R Kotagal MBBS MSc.

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Mehta, S., Atherton, H., Schoettker, P. et al. Differential Markers for Regionalization. J Perinatol 20, 366–372 (2000). https://doi.org/10.1038/sj.jp.7200391

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  • DOI: https://doi.org/10.1038/sj.jp.7200391

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