This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (16)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Herman A. Hein, MD

JAMA. 1986;255(14):1899-1903.

Abstract
Small Iowa community hospitals (fewer than 500 deliveries annually) are currently the site of approximately 37% of hospital births in the state. Many of these facilities face severe financial constraints aggravated by reduced Medicare payments and diagnosis-related group payment mechanisms. The quality and quantity of services provided by small hospitals are illustrated by birth and mortality data for the period that spans the development of Iowa's regionalized perinatal care system. Small hospitals appear to compare very favorably when matched with their larger level I counterparts with regard to neonatal mortality rates, incidence of births of very-low-birth-weight neonates, survival of very-low-birth-weight neonates, occurrence of neonatal deaths relative to the total birth population, and incidence of neonatal morbidities. Because these hospitals provide valuable services in Iowa's perinatal care system, their closure may seriously compromise perinatal health care for rural lowans.

(JAMA 1986;255:1899-1903)

Author Affiliations
From the Department of Pediatrics, University Hospitals and Clinics, Iowa City.

Footnotes
Reprint requests to Department of Pediatrics, University Hospitals, Room W214, Iowa City, IA 52242 (Dr Hein).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Bypassing Rural Hospitals for Obstetrics Care
Bronstein and Morrisey
Journal of Health Politics, Policy and Law 1991;16:87-118.
ABSTRACT  

The Choice of Place of Delivery: Effect of Hospital Level on Mortality in All Singleton Births in New York City
Paneth et al.
Arch Pediatr Adolesc Med 1987;141:60-64.
ABSTRACT  

The Changing Pattern of Neonatal Mortality in a Regionalized System of Perinatal Care
Hein and Lathrop
Arch Pediatr Adolesc Med 1986;140:989-993.
ABSTRACT  

The Future of Rural Maternity Units
Cunningham
JAMA 1986;256:1001-1002.
ABSTRACT  

Small Maternity Services
Klein
JAMA 1986;255:1923-1924.
ABSTRACT