Birth outcomes by level of obstetric care in Finland: a catchment area based analysis.
OBJECTIVE
To study whether hospitals of different levels are equally safe places to give birth in a regionalised system of care.


METHODS
This was a population based, cross sectional survey comparing birth outcomes in nationwide catchment areas of different levels of hospital care. All women and low risk women were examined separately.


METHODS
The study population comprised all women who gave birth in Finland in 1987-88. The data were obtained from the Finnish Medical Registry, complemented by official data.


RESULTS
No statistically significant differences were found in crude or birthweight specific perinatal mortality rates between the catchment areas, nor did the other outcomes studied favour tertiary care compared with other levels of care in the area based analysis.


CONCLUSIONS
In a regionalised system of birth care with a proper referral system, small local hospitals are as safe places to give birth as tertiary care hospitals.
Department of Public Health University of Helsinki, Finland.
K
K
Viisainen
M
M
Gissler
E
E
Hemminki
D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000592:standards*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006771:Hospitals, Maternity / Q000592:standards*; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D009774:Obstetrics / Q000592:standards*; D011247:Pregnancy; D011256:Pregnancy Outcome; D017584:Reproductive History; D012307:Risk Factors