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Study of Birth Volume Finds Many Isolated, Low-Volume Obstetric Hospitals Located in Rural Areas

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Timely access to clinically appropriate obstetric services is critical to the provision of high-quality perinatal care. A new study published in JAMA Network Open found birth volumes varied among US obstetric hospitals, with many isolated, low-volume obstetric hospitals located in rural areas, suggesting a need to ensure access to perinatal care.

In this cohort study of 34,054,951 births at 3207 obstetric hospitals identified using American Hospital Association data from 2010 to 2018, 56.8% of infants were born in high-volume obstetric hospitals, and 37.4% of hospitals were low volume. Among low-volume hospitals, 18.9% were isolated and 58.4% of these were rural.

Marked variations were found in birth volume, geographic distribution, proximity, and urban adjacency among US obstetric hospitals from 2010 to 2018. The findings related to geographic isolation and rural-urban distribution of low-volume obstetric hospitals suggest the need to balance proximity with volume to optimize effective referral and access to high-quality perinatal care.

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