Regionalization of perinatal care in Wisconsin: a changing health care environment.

Wisconsin has recently experienced a rapid increase in the number of neonatal intensive care units (NICUs), from 6 in the 1970s to 18 in 2003. Over the last year, the Wisconsin Association for Perinatal Care (WAPC) convened meetings in response to threats to regionalized care and worsening of perinatal outcomes, noted especially in some racial/ethnic groups. WAPC defined actions to address quality improvement, including adoption of designations for levels of care published by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, definition of perinatal outcomes sensitive to quality of care, collection and analysis of outcome data, and continued statewide discussions about the status of regionalized care and outcomes. WAPC invites others to join in cooperative efforts to address quality of care and responsible utilization of resources.