The North Carolina Perinatal Regionalization Study
Objectives
Systems of regionalized perinatal care arose nationally and in North Carolina in the 1970’s, and have been associated with decreases in neonatal mortality. These systems concentrate the highest level of care for high-risk pregnant women and newborns in hospitals equipped with subspecialty services and advanced technology.
The objectives of this study are to examine changes in the distribution and availability of neonatal services in the six perinatal care regions of North Carolina from 1996 to 2006, and to compare these changes with birth weight and infant mortality trends during the same time span. The study will also examine changes in the distribution/availability of high-risk obstetric services in North Carolina. It will explore associations between level of newborn care and mortality along with issues such as volume, region, race/ethnicity, and staffing.
We also would like to update information about the nurseries and hospital for the statewide hospital locator list. This list is used to make it easier for tertiary care centers to get pregnant mothers and babies back to their home communities as quickly as possible. It was last updated in 2004.
Methods
This project requires two sets of data. The first is being drawn from the State Center for Health Statistics. The State Center for Health Statistics maintains mortality and morbidity data for every county and region of the state. Hospital surveys to learn about the types of services they have provided over ten years will generate the second dataset. Hospital staff from across the state are being asked to complete a 12-question survey regarding their neonatal services since 1996 to be included in the analysis. A copy of the survey is located on this website. This information in turn will allow the hospitals to be classified into levels of care. The datasets will then need to be linked and compared. The Neonatal Outreach Educators and Trainers along with the Division of Public Health are providing leadership for this component of the study.
Impact
This study is being conducted to augment the information collected ten years ago by Stiles et al, which reviewed regionalization in North Carolina. The results will be shared with professional organizations in North Carolina such as Perinatal Quality Collaborative of NC, the NC Perinatal Health Committee and the NC OB/GYN Society. Once the study is complete, a group of stakeholders and other interested partners will be convened to discuss the results and any potential action. This study has the potential to improve North Carolina’s understanding of where high-risk mothers and infants are receiving their services and how the level of care they receive impacts birth outcomes. Ultimately, it could assist the state in improving access to appropriate, quality health care for mothers and infants statewide.
Other Important Details
This study was reviewed by the University of North Carolina Office of Human Research Ethics (#07-1951). The Institutional Review Board determined that this submission does not constitute human subjects research as defined under federal regulations and does not require IRB approval.