Strobino Donna M, Silver Gillian Beth, Allston Adam A, Grason Holly A
Women's and Children's Health Policy Center, Department of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
J Perinatol. 2003 Dec;23(8):610-9. doi: 10.1038/sj.jp.7210993.
To describe perinatal linkages among hospitals, changes in their numbers and their impact on relationships among high-risk providers in local communities.
Data were obtained about the organization of perinatal services in 1996-1999 from a cross-sectional study evaluating fetal and infant mortality review (FIMR) programs nationwide. Geographic areas were sampled based on region, population density, and the presence of a FIMR. A local health department representative was interviewed in 76% (N=193) of eligible communities; 188 provided data about hospitals.
Linkages among all hospitals were reported in 143 communities and with a subspecialty hospital in 122. All but 12 communities had a maternity hospital, and changes in the number of hospitals occurred in 49 communities. Decreases in the number of Level II hospitals were related to changes in relationships among providers of high-risk care for mothers and newborns; they were associated with changing relationships only for mothers in Level I hospitals. These relations were noted only where established provider relationships existed.
Decreases in the number of maternity hospitals affect provider relationships in communities, but only where there are established linkages among hospitals.
描述医院之间的围产期联系、其数量变化以及它们对当地社区高危医疗服务提供者之间关系的影响。
数据来自1996 - 1999年一项评估全国胎儿和婴儿死亡评审（FIMR）项目的横断面研究，该研究涉及围产期服务的组织情况。根据地区、人口密度和FIMR的存在情况对地理区域进行抽样。在76%（N = 193）符合条件的社区中采访了当地卫生部门代表；188个社区提供了有关医院的数据。
143个社区报告了所有医院之间的联系，122个社区报告了与专科医院的联系。除12个社区外，所有社区都有妇产医院，49个社区的医院数量发生了变化。二级医院数量的减少与母婴高危护理提供者之间关系的变化有关；仅与一级医院中母亲的关系变化有关。这些关系仅在已建立的医疗服务提供者关系存在的地方被注意到。
妇产医院数量的减少会影响社区中的医疗服务提供者关系，但仅在医院之间存在既定联系的地方才会如此。
