Regionalization of infant transports: the southern California experience and its implications. I: Referral pattern.

The development and implementation of neonatal intensive care services have been essential components of perinatal regionalization during the past two decades. The transport of critically ill infants to regional neonatal intensive care units has played an important role in improving neonatal outcome. This article presents a profile of Southern California's 10-year infant transport experience (1979 through 1988) in terms of the following indicators: transport volume, cross-county referrals, distance travelled, referral pattern, and birth weight pattern. Findings point to the necessity of focusing attention on several critical issues confronting Southern California's neonatal services in the 1990s. They include adequacy of tertiary or intermediate bed capacity in neonatal intensive care units; appropriateness of existing infant referral practices; impact of maternal-fetal transports; availability of financing resources; and overall differences in morbidity and mortality rates between transported and nontransported infants in subpopulations.