title: Declines in patient volume: an obstetrics and gynecology teaching program's response.
abstract: Historically, University teaching hospitals have been the primary providers of health care to the indigent population. With the advent of managed health-care plans, the university hospitals have seen a rapid decline in their obstetrical patient populations. This decrease is reflected in the numbers of deliveries and gynecological surgeries. From 1990 to 1995, these changes resulted in a significant decline in deliveries at our hospital, the Lyndon B. Johnson General Hospital. To reverse this ominous trend, we instituted a variety of changes resulting in a more patient-centered system and found an improvement in the numbers of obstetrical patients. In the following report, we describe these changes and the subsequent outcome.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center, Houston, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Curtis
authors.forename: J
authors.initials: J
authors.lastname: Riggs
authors.forename: J D
authors.initials: JD
authors.lastname: Blanco
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D006745:Hospital Bed Capacity, 300 to 499; D006785:Hospitals, University / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency; D008489:Medical Indigency / Q000706:statistics & numerical data; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011446:Prospective Studies; D013781:Texas / Q000453:epidemiology