Consolidation of the perinatal care system and workload of obstetricians: an ecological study in Japan

Frontiers in Global Women's Health

Global Women's Health

Sanae Hattori¹  Nanako Tamiya¹  Nobuo Sakata²  Miho Ishimaru³ 

[1] Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan;Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan;Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan;Department of Oral Health Promotion, Graduated School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan;

关键词: perinatal care;    delivery;    obstetrician;    workload;    ecological study;   

DOI  :  10.3389/fgwh.2023.1030443

 received in 2022-08-29, accepted in 2023-03-07,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesWe examined the relationship between consolidation of delivery and the workload of obstetricians working at perinatal centers.MethodsWe conducted a descriptive analysis using perinatal care areas classified into three types (metropolitan, provincial, and rural). We calculated the Herfindahl–Hirschman Index (HHI) as an index of consolidation and the proportion of the deliveries at clinics as an indicator of the low-risk deliveries and the deliveries per center obstetrician as an indicator of obstetricians’ workload. We used >150 deliveries yearly as an excess indicator. The correlation between the HHI and obstetricians' workload and the proportion of deliveries at clinics was examined using the Pearson correlation coefficient.ResultsThe proportion of areas with  >150 deliveries yearly was higher in the consolidated areas. In provincial areas, obstetricians’ workload was positively correlated with the HHI and was negatively correlated with the proportion of deliveries at clinics.ConclusionsThe obstetricians' workload may be increasing where more consolidation occurs. In provincial areas, the center obstetrician's workload could be reduced not only by consolidation but also by sharing the role of handling low-risk deliveries with clinics and hospitals with obstetric units other than perinatal centers.

【 授权许可】

Unknown   
© 2023 Hattori, Sakata, Ishimaru and Tamiya.