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Outcomes, safety, and resource utilization in a collaborative care birth center program compared with traditional physician-based perinatal care.

Debra J Jackson·Janet M Lang·William H Swartz·Theodore G Ganiats·Judith Fullerton·Jeffrey Ecker·Uyensa Nguyen
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Abstract

OBJECTIVE: We compared outcomes, safety, and resource utilization in a collaborative management birth center model of perinatal care versus traditional physician-based care. 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.

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AdultBirthing CentersCaliforniaCase ManagementCohort StudiesCooperative BehaviorDelivery of Health Care, IntegratedDelivery, ObstetricFemaleHealth ResourcesHealth Services ResearchHospitalizationHumansInfant, NewbornModels, OrganizationalNurse MidwivesObstetricsOutcome and Process Assessment, Health CarePhysician-Nurse RelationsPregnancyPregnancy ComplicationsPrenatal CareProspective StudiesComparative StudyJournal ArticleResearch Support, U.S. Gov't, P.H.S.

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Debra J Jackson, Janet M Lang, William H Swartz, Theodore G Ganiats, Judith Fullerton, Jeffrey Ecker, Uyensa Nguyen. 2003. Outcomes, safety, and resource utilization in a collaborative care birth center program compared with traditional physician-based perinatal care.. https://doi.org/10.2105/ajph.93.6.999

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