title: Laborist model of care: who is using it?
abstract: OBJECTIVE
  Utilization of the laborist model in the provision of obstetric (OB) care appears to be growing. In collaboration with the National Perinatal Information Center/Quality Analytic Services (NPIC/QAS), we assessed the utilization of this model of care delivery and hospital-level characteristics associated with its use.
  
  
  METHODS
  A cross-sectional electronic survey of all NPIC/QAS member hospitals (26 states) was performed in February 2010. Questions assessed staffing and clinical capabilities and utilization of laborists. The association between laborists and hospital-level characteristics were calculated using chi-square analyses or Fisher's exact tests for categorical variables and t tests for continuous variables.
  
  
  RESULTS
  Ninety-three percent of hospitals (69/74) responded and only those that provide OB services were analyzed (N = 68). Nearly 40% (25/68) of hospitals responded that they are utilizing laborists. Delivery volume is significantly associated with implementation of laborists whereas OB level, presence of residents and fellows, and geography were not.
  
  
  CONCLUSIONS
  Laborists are being introduced into the OB care delivery model rapidly. This is the first assessment of their use in a large sample of US hospitals. Given the millions of women who deliver each year, it is imperative to evaluate the impact of this model on patient safety and outcomes.
authors.affiliation: University of Pennsylvania, Department of Obstetrics and Gynecology, Maternal and Child Health Research Program, Philadelphia, PA, USA. ssrinivas@obgyn.upenn.edu
authors.forename: Sindhu K
authors.initials: SK
authors.lastname: Srinivas
authors.forename: Julie
authors.initials: J
authors.lastname: Shocksnider
authors.forename: Donna
authors.initials: D
authors.lastname: Caldwell
authors.forename: Scott
authors.initials: S
authors.lastname: Lorch
mesh_terms: D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D020445:Hospitalists / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007743:Labor, Obstetric; D008962:Models, Theoretical; D009774:Obstetrics; D009775:Obstetrics and Gynecology Department, Hospital; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce