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Comparative Study
. 2003 Jun;93(6):999-1006.
doi: 10.2105/ajph.93.6.999.

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

Debra J Jackson  1 , Janet M Lang, William H Swartz, Theodore G Ganiats, Judith Fullerton, Jeffrey Ecker, Uyensa Nguyen
Affiliations
Comparative Study

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

Debra J Jackson et al. Am J Public Health. 2003 Jun.

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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