Hostname: page-component-7479d7b7d-t6hkb Total loading time: 0 Render date: 2024-07-10T22:23:27.127Z Has data issue: false hasContentIssue false
  • English
  • Français

The Diffusion of Obstetric Technology into Rural U.S. Hospitals

Published online by Cambridge University Press:  10 March 2009

Roger A. Rosenblatt ,
Gregory R. Saunders ,
Carolyn J. Tressler ,
Eric H. Larson ,
Thomas S. Nesbitt  and
L. Gary Hart
Roger A. Rosenblatt
Affiliation:
University of Washington
Gregory R. Saunders
Affiliation:
University of Washington
Carolyn J. Tressler
Affiliation:
University of Washington
Eric H. Larson
Affiliation:
University of Washington
Thomas S. Nesbitt
Affiliation:
University of California, Sacramento
L. Gary Hart
Affiliation:
University of Washington
Get access Rights & Permissions [Opens in a new window]

Abstract

We determined the distribution and sophistication of obstetric technologies in all 80 maternity hospitals in the state of Washington and examined the effect of rural or urban location, birth volume, and physician staffing on technological intensity. Although smaller and more rural hospitals refer most premature and low-birth-weight infants to regional referral centers, sophisticated prenatal and intrapartum technologies are available in the majority of even the smallest and most remote rural units. Rural hospitals have slightly lower obstetrical intervention rates than do their urban counterparts, but the differences are not great.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 10 , Issue 3 , Summer 1994 , pp. 479 - 489
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.American Hospital Association guide to the health care field, 1990 edition. Chicago: American Hospital Association, 1990.Google Scholar
2.Banta, H. D., & Kemp, K. B. (eds.). The management of health care technology in nine countries. New York: Springer Publishing Company, 1982.Google Scholar
3.Black, D. P., & Fyfe, I. M.The safety of obstetric services in small communities in northern Ontario. Canadian Medical Association Journal, 1984, 130, 571–76.Google Scholar
4.Campbell, R., & Macfarlane, A.Place of delivery: A review. British Journal of Obstetrics and Gynaecology, 1986, 93, 675–83.Google Scholar
5.Chalmers, I.The work of the National Perinatal Epidemiology Unit: One example of technology assessment in perinatal care. International Journal of Technology Assessmen in Health Care, 1991, 7, 430–59.Google Scholar
6.Chalmers, I., Enkins, M., & Keirse, M. J. (eds.). Effective care in pregnancy and childbirth. Oxford, UK: Oxford University Press, 1989.Google Scholar
7.Clark, L., Mugford, M., & Paterson, C.How does the mode of delivery affect the cost of maternity care? British Journal of Obstetrics and Gynaecology, 1991, 98, 519–23.Google Scholar
8.Eddy, D. M.Selecting technologies for assessment. International Journal of Technology Assessment in Health Care, 1989, 5, 485–501.Google Scholar
9.Feinglass, J., Martin, G. J., & Sen, A.The financial effect of physician practice style on hospital resource use. Health Services Research, 1991, 26, 183–205.Google Scholar
10.Finkler, M. D., & Wirtschafter, D. D.Cost-effectiveness and obstetric services. Medical Care, 1991, 29, 951–63.Google Scholar
11.Gortmaker, S., Sobol, A., Clark, C., et al. The survival of very low-birth weight infants by level of hospital of birth: A population study of perinatal systems in four states. American Journal of Obstetrics and Gynecology, 1985, 152, 517–24.Google Scholar
12.Hall, M. A.The defensive effect of medical practice policies in malpractice litigation. Law and Contemporary Problems, 1991, 54, 119–45.Google Scholar
13.Havighurst, C. C.Practice guidelines as legal standards governing physician liability. Law and Contemporary Problems, 1991, 54, 87–117.Google Scholar
14.Larson, E. B., van Belle, G., Shy, K. K., et al. Fetal monitoring and predictions by clinicians: Observations during a randomized clinical trial in very low birth weight infants. Obstetrics and Gynecology, 1989, 74, 584–89.Google Scholar
15.Larson, E. H., Hart, L. G., & Rosenblatt, R. A.Rural residence and poor birth outcome in Washington State. Journal of Rural Health, 1992, 8, 162–70.Google Scholar
16.Rand McNally road atlas and travel guide—United States, Canada, Mexico. Chicago: Rand McNally & Co., 1990.Google Scholar
17.Rosenblatt, R. A.The perinatal paradox: Doing more and accomplishing less. Health Affairs, 1989, 8, 158–68.Google Scholar
18.Rosenblatt, R. A., Reinken, J., & Shoemack, P.Is obstetrics safe in small hospitals? Evidence from New Zealand's regionalised perinatal system. Lancet, 1985, 2, 429–32.Google Scholar
19.The sourcebook of ZIP code demographics, 7th edition. Fairfax, VA: CACI Marketing Systems, 1990.Google Scholar
20.Vallgarda, S.Increased obstetric activity: A new meaning to “induced labour”? Journal of Epidemiology and Community Health, 1989, 43, 48–52.Google Scholar