Rural Women Giving Birth in Non-Local Hospitals: Implications for Obstetric Access and Quality

Year(s) Funded:
Topic(s): , , , ,
Project Lead: Katy Kozhimannil

Appropriate referral of high-risk women for a higher level of obstetric and/or neonatal care that is not provided in local hospitals is a crucial element of providing high-quality maternity care. However, out-migration of low-risk women may contribute to the loss of obstetric services in local hospitals by reducing volume to a point where it is not feasible from a financial perspective or advisable from a quality perspective to maintain the service line. The purpose of this project is to: 1) analyze data from nine geographically diverse states on delivery by rural women at non-local hospitals; 2) characterize the roles of medical vs. non-medical factors in delivery at a non-local hospital by identifying lower-risk and higher-risk women using established criteria; and 3) analyze the relationship between delivery at a non-local hospital and obstetric quality measures (e.g., low-risk cesarean rate, labor induction without medical indication, cesarean delivery without medical indication).

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