Minority Health Archive

Deregionalization of Neonatal Intensive Care in Urban Areas

Howell, Embry M and Richardson, Douglas and Ginsburg, Paul and Foot, Barbara (2002) Deregionalization of Neonatal Intensive Care in Urban Areas. American Journal of Public Health, 92 (1). pp. 119-124. ISSN 0090-0036

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Objectives. This report describes the extent of deregionalization of neonatal intensive care in urban areas of the United States in the 1980s and 1990s and the factors associated with it. Methods. We conducted a 15-year retrospective analysis of secondary data from US metropolitan statistical areas. Primary outcome measures are number of neonatal intensive care unit (NICU) beds, number of NICU hospitals, and number of small NICUs. Results. Growth in the supply of NICU care has outpaced the need. During the study period (1980-1995), the number of hospitals grew by 99%, the number of NICU beds by 138%, and the number of neonatologists by 268%. In contrast, the growth in needed bed days was only 84%. Of greater concern, the number of beds in small NICU facilities continues to grow. Local regulatory and practice characteristics are important in explaining this growth. Conclusions. Local policymakers should examine the factors that facilitate the proliferation of services, especially the development of small NICUs. Policies that encourage cooperative efforts by hospitals should be developed. Eliminating small NICUs would not restrict the NICU bed supply in most metropolitan statistical areas.

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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: deregionalization, neonatal intensive care, urban areas
Subjects: Health > Policy
Health > Prenatal & Pediatric Health
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Depositing User: Kismet Loftin-Bell
Date Deposited: 18 Oct 2005
Last Modified: 07 Jul 2011 15:09
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/289

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