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Efficacy of Regionalization of Perinatal/Neonatal Care-Reply

Efficacy of Regionalization of Perinatal/Neonatal Care-Reply Abstract In Reply.—I very much appreciate Dr Bedrick's thoughtful response to my recent editorial. Since few of us have the perspective that affords us a global view of a national issue such as perinatal regionalization, it is imperative that there be open debate and exchange of ideas and perceptions. I am delighted that Dr Bedrick does not believe that regionalization has deteriorated into turf guarding, and I hope he is correct. I do not possess either his personal experience or his optimism. When I look at the events of the past several years, I am pessimistic. Patients in need have been refused admission, patients have been transferred across state lines because of the lack of a payment source, and a two-tiered health care delivery system, private and public, has developed. These are examples of events now occurring that I believe are incompatible with the original goals of regionalization.1 When References 1. Toward Improving the Outcome of Pregnancy . White Plains, NY, National March of Dimes Foundation, 1976. 2. Paneth N, Kiely JL, Wallenstein S, et al: The choice of place of delivery: Effect of hospital level on mortality in all singleton births in New York City . AJDC 1987;141:60-64. 3. McCormick MC, Shapiro S, Starfield BH: The regionalization of perinatal services: Summary of the evaluation of a national demonstration program . JAMA 1985;253:799-804.Crossref 4. Lee KS, Paneth N, Gartner LM, et al: Neonatal mortality: An analysis of the recent improvement in the United States . Am J Public Health 1980;70:15-21.Crossref 5. Hein H, Brown CJ: Neonatal mortality review: A basis for improving care . Pediatrics 1981;68:504-509. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Efficacy of Regionalization of Perinatal/Neonatal Care-Reply

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460100016004
Publisher site
See Article on Publisher Site

Abstract

Abstract In Reply.—I very much appreciate Dr Bedrick's thoughtful response to my recent editorial. Since few of us have the perspective that affords us a global view of a national issue such as perinatal regionalization, it is imperative that there be open debate and exchange of ideas and perceptions. I am delighted that Dr Bedrick does not believe that regionalization has deteriorated into turf guarding, and I hope he is correct. I do not possess either his personal experience or his optimism. When I look at the events of the past several years, I am pessimistic. Patients in need have been refused admission, patients have been transferred across state lines because of the lack of a payment source, and a two-tiered health care delivery system, private and public, has developed. These are examples of events now occurring that I believe are incompatible with the original goals of regionalization.1 When References 1. Toward Improving the Outcome of Pregnancy . White Plains, NY, National March of Dimes Foundation, 1976. 2. Paneth N, Kiely JL, Wallenstein S, et al: The choice of place of delivery: Effect of hospital level on mortality in all singleton births in New York City . AJDC 1987;141:60-64. 3. McCormick MC, Shapiro S, Starfield BH: The regionalization of perinatal services: Summary of the evaluation of a national demonstration program . JAMA 1985;253:799-804.Crossref 4. Lee KS, Paneth N, Gartner LM, et al: Neonatal mortality: An analysis of the recent improvement in the United States . Am J Public Health 1980;70:15-21.Crossref 5. Hein H, Brown CJ: Neonatal mortality review: A basis for improving care . Pediatrics 1981;68:504-509.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1987

References