title: Neonatal outcomes and quality of care in level II perinatal centers supported by a children's hospital-medical school level III program.
abstract: OBJECTIVE
  Eight Level II perinatal centers developed contracts with the children's hospital to provide consultative neonatal patient care, education, and administrative support. The purpose of the present study was to evaluate infant outcomes and quality of care during a 3-year period of the program, 1994 to 1996.
  
  
  METHODS
  Neonatal mortality rates were determined for the 18,703 live births. Quality of care was assessed for 30 infants who died at the Level II centers and 315 infants transferred to the children's hospital.
  
  
  RESULTS
  The neonatal mortality rate was 2.2/1000 live births. Quality-of-care issues primarily involved 80 "drop-in" deliveries </=32 weeks' gestation and seven-term infants with perinatal asphyxia. Enhanced neonatal care at the Level II special care nurseries was evident from procedures performed and the clinical course of 1382 infants not transferred.
  
  
  CONCLUSIONS
  Further improvement is possible with comprehensive prenatal care avoiding deliveries <32 weeks' gestation and improved response to acute intrapartum emergencies.
authors.affiliation: Children's Mercy Hospitals & Clinics/University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Hall
authors.forename: Susan R
authors.initials: SR
authors.lastname: Santos
authors.forename: Susan L
authors.initials: SL
authors.lastname: Teasley
authors.forename: Mary Jean
authors.initials: MJ
authors.lastname: Brown
mesh_terms: D005315:Fetal Diseases / Q000628:therapy*; D017052:Hospital Mortality; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D018743:Perinatal Care / Q000706:statistics & numerical data*; D010500:Perinatology / Q000706:statistics & numerical data*; D015397:Program Evaluation; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D013997:Time Factors