title: Effects of changing health care financial policy on very low birthweight neonatal outcomes.
abstract: BACKGROUND
  Our objective was to determine whether perinatal referral patterns and clinical outcomes for very low birthweight infants changed in relation to changing Medicaid financial policies in coastal South Carolina.
  
  
  METHODS
  Referral patterns and outcome indicators for very low birthweight infants were compared during two periods in a cohort design.
  
  
  RESULTS
  A total of 520 infants were identified over two funding periods. A decrease in the proportion of nonwhite very low birthweight infants was identified. There was an increase in very low birthweight infants with Medicaid funding born outside our level III center.
  
  
  CONCLUSIONS
  Changes in financial public policy have been successful in the movement of low risk pregnancies into the private sector. However, an increased proportion of deliveries of very low birthweight infants occurred outside the level III center.
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, USA.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Lessaris
authors.forename: David J
authors.initials: DJ
authors.lastname: Annibale
authors.forename: W Michael
authors.initials: WM
authors.lastname: Southgate
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Hulsey
authors.forename: Bryan L
authors.initials: BL
authors.lastname: Ohning
mesh_terms: D001034:Apgar Score; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006291:Health Policy / Q000191:economics*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care / Q000191:economics* / Q000458:organization & administration*; D018743:Perinatal Care / Q000191:economics* / Q000458:organization & administration*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000191:economics; D012017:Referral and Consultation / Q000191:economics* / Q000458:organization & administration*; D013022:South Carolina