TY - JOUR
T1 - Outcomes, Safety, and Resource Utilization in a Collaborative Care Birth Center Program Compared with Traditional Physician-Based Perinatal Care
AU - Jackson, Debra J.
AU - Lang, Janet M.
AU - Swartz, William H.
AU - Ganiats, Theodore G.
AU - Fullerton, Judith
AU - Ecker, Jeffrey
AU - Nguyen, Uyensa
PY - 2003/6
Y1 - 2003/6
N2 - Objective. We compared outcomes, safety, and resource utilization in a collaborative management birth center model of perinatal care versus traditional physician-based ca re. Methods. We studied 2957 low-risk, low-income women: 1808 receiving collaborative care and 1149 receiving traditional care. Results. Major antepartum (adjusted risk difference [RD]=-0.5%; 95% confidence interval [CI]=-2.5, 1.5), intrapartum (adjusted RD=0.8%; 95% CI=-2.4, 4.0), and neonatal (adjusted RD=-1.8%; 95% CI=-3.8, 0.1) complications were similar, as were neonatal intensive care unit admissions (adjusted RD=-1.3%; 95% CI=-3.8, 1.1). Collaborative care had a greater number of normal spontaneous vaginal deliveries (adjusted RD=14.9%; 95% CI=11.5, 18.3) and less use of epidural anesthesia (adjusted RD=-35.7%; 95% CI=-39.5, -31.8). Conclusions. For low-risk women, both scenarios result in safe outcomes for mothers and babies. However, fewer operative deliveries and medical resources were used in collaborative care.
AB - Objective. We compared outcomes, safety, and resource utilization in a collaborative management birth center model of perinatal care versus traditional physician-based ca re. Methods. We studied 2957 low-risk, low-income women: 1808 receiving collaborative care and 1149 receiving traditional care. Results. Major antepartum (adjusted risk difference [RD]=-0.5%; 95% confidence interval [CI]=-2.5, 1.5), intrapartum (adjusted RD=0.8%; 95% CI=-2.4, 4.0), and neonatal (adjusted RD=-1.8%; 95% CI=-3.8, 0.1) complications were similar, as were neonatal intensive care unit admissions (adjusted RD=-1.3%; 95% CI=-3.8, 1.1). Collaborative care had a greater number of normal spontaneous vaginal deliveries (adjusted RD=14.9%; 95% CI=11.5, 18.3) and less use of epidural anesthesia (adjusted RD=-35.7%; 95% CI=-39.5, -31.8). Conclusions. For low-risk women, both scenarios result in safe outcomes for mothers and babies. However, fewer operative deliveries and medical resources were used in collaborative care.
UR - http://www.scopus.com/inward/record.url?scp=0037902107&partnerID=8YFLogxK
U2 - 10.2105/AJPH.93.6.999
DO - 10.2105/AJPH.93.6.999
M3 - Article
C2 - 12773368
AN - SCOPUS:0037902107
SN - 0090-0036
VL - 93
SP - 999
EP - 1006
JO - American Journal of Public Health
JF - American Journal of Public Health
IS - 6
ER -