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Local Health Department Perspectives on Linkages Among Birthing Hospitals

Journal of Perinatology volume 23, pages 610–619 (2003)Cite this article

Abstract

OBJECTIVES: To describe perinatal linkages among hospitals, changes in their numbers and their impact on relationships among high-risk providers in local communities.

STUDY DESIGN: 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.

RESULTS: 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.

CONCLUSIONS: Decreases in the number of maternity hospitals affect provider relationships in communities, but only where there are established linkages among hospitals.

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Acknowledgements

We acknowledge the State and local public health officials and FIMR and perinatal initiative coordinators who participated in this study. Their willingness to share information through telephone interviews about the important work they are doing required a significant commitment of time, expertise, and effort — we remain in their debt. We also acknowledge the sage advice provided by Ann Koontz on all aspects of the research reported here.

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Authors and Affiliations

  1. Department of Population and Family Health Sciences, Women's and Children's Health Policy Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Donna M Strobino PhD, Gillian Beth Silver MPH, Adam A Allston MPH, MSW & Holly A Grason MA

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  1. Donna M Strobino PhD
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  2. Gillian Beth Silver MPH
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  3. Adam A Allston MPH, MSW
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  4. Holly A Grason MA
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Development of this manuscript was funded by project # U93 MC 00101 from the Maternal and Child Health Bureau, HRSA, US Department of Health and Human Services (Title V of the Social Security Act). Opinions expressed in this publication are those of the authors and do not necessarily reflect the views or policies of the Bureau, HRSA, or the Department of Health and Human Services.

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Strobino, D., Beth Silver, G., Allston, A. et al. Local Health Department Perspectives on Linkages Among Birthing Hospitals. J Perinatol 23, 610–619 (2003). https://doi.org/10.1038/sj.jp.7210993

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