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- W2610769144 abstract "INTRODUCTION: Lack of coordination of care across birth settings (home-hospital, rural-urban) has been associated with adverse maternal-fetal outcomes. The US Birth Place Mapping Study examines associations between regulation, scope of practice, interprofessional collaboration with maternal-newborn outcomes, and equitable care for at-risk populations. METHODS: We populated a 50-state database with published regulatory data on scope of practice across birth settings. A nationwide survey of 92 regulatory experts verified the “on the ground” relevance, importance, and realities of collaboration. Content validation led to a 49-item weighted integration scoring system (item scores range 1-4). Composite summary scores were then used to rank states on the regulatory and practice environment for midwives and physicians across home, birth centers and hospitals. Higher scores indicate more integration and collaboration across all providers and all settings. Using CDC, Area Resource and CMS data, we calculated correlation coefficients between integration scores and selected outcomes (eg. SVD, VBAC, breastfeeding, cesarean, induction, neonatal mortality, LBW) in each state, controlling for race and type of provider. RESULTS: Integration scores ranged from 17-59, (North Carolina lowest – 17, Washington highest – 59). We report results through 4 interactive data maps, displaying quartiles for level of integration, linked to optimal and adverse outcomes, and access to care, by state. Rates of birth by race, Medicaid coverage, and location are displayed both by region and by individual states. CONCLUSION: This scoring system identifies barriers to collaboration in maternity care, and can inform health human resource planning and policy to improve regional access to high quality maternity care." @default.
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- W2610769144 date "2017-05-01" @default.
- W2610769144 modified "2023-09-26" @default.
- W2610769144 title "Mapping Collaboration Across Birth Settings in the United States: Access, Equity, and Outcomes [2R]" @default.
- W2610769144 doi "https://doi.org/10.1097/01.aog.0000514147.10020.9f" @default.
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