American Academy of Pediatrics. Perinatal Sect. Annual Spring meeting. Phoenix AZ USA, 1994/04/11.
The increasingly competitive health care environment may undermine effective traditional regional organizations.
It is urgent to document the benefits of perinatal regionalization for the emerging health care system.
We present a case study that illustrates many of the challenges to and benefits of perinatal regionalization in the 1990s.
The consultant team interviewed stakeholders in area hospitals, health maintenance organizations, insurance companies, businesses, state agencies, and community groups, and analyzed quantitative data on newborn discharges.
The existing system worked remarkably well for clinical care, training, referrals, and provider and patient satisfaction.
There was a high level of inter-hospital collaboration and regional leadership in obstetrics and pediatrics, but strong and growing competition between their hospitals.
Hospital administrators enumerated the competitive threats that obligated them to compete and the financial disincentives to support the regional structures.
Business leaders and insurance executives emphasized the need to control costs.
Analysis of discharge data showed marginal adequacy of NICU beds but maldistribution between NICUs, particularly between level III and level II units.
The consultants recommended no new beds based on population projections, declining lengths of stay nationally, and substantial gains available from aggressive back-transport of convales.
Mots-clés Pascal : Organisation hospitalière, Néonatologie, Unité soin intensif, Etats Unis, Système santé, Homme, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Hospital organization, Neonatology, Intensive care unit, United States, Health system, Human, North America, America
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0514190
Code Inist : 002B30A04D. Création : 01/03/1996.