Rosenblatt R A, Mayfield J A, Hart L G, Baldwin L M
West J Med. 1988 Jul;149(1):98-102.
We evaluated the extent to which the regionalization of perinatal care in Washington State has succeeded in concentrating high-risk pregnancies in technologically appropriate referral centers and in reducing differences in neonatal outcome among hospitals. Of all infants weighing less than 1,500 grams born between 1980 and 1983, nearly 68% were delivered in level III hospitals, although only 24% of all babies are born in these hospitals, indicating that the state is highly regionalized. Neonatal outcomes-as measured by standardized mortality ratios-are similar in level I, II and III hospitals and are not greatly influenced by the rural or urban location of the hospital. The most promising strategy for further reducing neonatal mortality is to decrease the number and proportion of very-low-birth-weight births.
我们评估了华盛顿州围产期护理区域化在将高危妊娠集中于技术上合适的转诊中心以及减少医院间新生儿结局差异方面取得成功的程度。在1980年至1983年出生的所有体重不足1500克的婴儿中，近68%在三级医院分娩，尽管所有婴儿中只有24%在这些医院出生，这表明该州的区域化程度很高。一级、二级和三级医院的新生儿结局（以标准化死亡率衡量）相似，且不受医院农村或城市位置的很大影响。进一步降低新生儿死亡率最有前景的策略是减少极低出生体重儿的数量和比例。
