Goldenberg R L, Hanson S, Wayne J B, Koski J
South Med J. 1985 Jun;78(6):657-60. doi: 10.1097/00007611-198506000-00010.
Although regionalization of perinatal health care services has received credit for much of the recent improvement in neonatal mortality, until now no measurement of regionalization has been proposed. The measurement presented in this paper--the average of the percentage of infants of very low birthweight and neonatal deaths occurring among residents of a geographic area at a perinatal center--provides a means of comparing the extent of perinatal regionalization in various geographic areas and time periods. Despite continued disparities in the degree of regionalization from one perinatal district to another, Alabama's perinatal system became substantially regionalized from 1970 to 1980. The lower mortality for infants of very low birthweight born at a perinatal center suggests that if Alabama were more completely regionalized, its neonatal mortality would be improved.
尽管围产期保健服务的区域化被认为是近期新生儿死亡率大幅下降的主要原因,但迄今为止,尚未有人提出对区域化的衡量标准。本文提出的衡量标准——围产期中心所在地理区域居民中极低出生体重婴儿百分比与新生儿死亡数的平均值——提供了一种比较不同地理区域和时间段围产期区域化程度的方法。尽管不同围产区分区域化程度仍存在差异,但阿拉巴马州的围产期系统在1970年至1980年间已基本实现区域化。在围产期中心出生的极低出生体重婴儿死亡率较低,这表明如果阿拉巴马州能更全面地实现区域化,其新生儿死亡率将会降低。