Monitoring health care

Manpower for obstetrics and gynecology. II. Characteristics of patients; their diagnoses and care

A further report from the cooperative manpower study of the University of Southern California American College of Obstetricians and Gynecologists has identified characteristics of patients and their diagnoses and classified types of patient-physician encounters. Obstetrician-gynecologists care for women mainly between the ages of 20 and 44, deal two thirds of the time with only five diagnostic categories in the office and 10 in the hospital, and provide primary care in 78.2% of all patient encounters.

Monitoring perinatal mortality rates: California, 1970 to 1976

Recent developments have emphasized the need to monitor perinatal mortality statistics by small geographic areas. A method is presented which separates county-specific perinatal mortality rates into a component reflective of socioeconomic, behavioral, and environmental variables, and a component that relates more directly to hospital-based intra- and postpartum care. Major differences in geographic variations were observed between the crude rate and the two components. An arbitrary index of the need for perinatal health services was created by combining the two components with the number of perinatal deaths in each county. Although there are some obvious limitations, the index serves as a useful guidepost for monitoring perinatal mortality on a statewide basis.

Suburbia: a small obstetric hospital in Brisbane

In a small suburban obstetric hospital, during the period from July 1, 1963 to December 31, 1970, 3760 private and intermediate patients were delivered by suburban general practitioners. The number of perinatal deaths in hospital were nine deaths per 1000 births, both live and still. During the same period, 4873 private and intermediate patients were delivered by suburban general practitioners in the private/intermediate section of a large centrally sited obstetric teaching hospital. The number of perinatal deaths in hospital were 18.9 per 1000 births, live and still. The reason for, and the implications of, these results are discussed.

Perinatal mortality rate at a community hospital, 1956 to 1975

This paper is a review of the perinatal mortality rate and its components stillbirths and neonatal deaths, for the years 1956 through 1975 at Memorial General Hospital, Las Cruces, New Mexico. It is an attempt to assess major medical factors, such as specialization and cesarean section, and weigh their effect on these indices of the quality of perinatal medical care. Other factors considered in the analysis were: ages of mothers, parity, birth weights, and socioeconomic, educational, and motivational factors. The apparent impact of direct medical care factors is considerably less than would be expected.