title: Applying the ecology model to perinatal medicine: from a regional population-based study.
abstract: OBJECTIVE
  Ecology model is useful to provide a framework for organizing medical care. We aimed to see if the ecology model is applicable to perinatal care in Japan.
  
  
  METHODS
  On a population-based approach, we had 53,461 deliveries in Miyazaki from 2001 to 2005. In comparison, we used all of the 106,613 deliveries in Tokyo in 2009. Women were divided into 4 grades by risk-allocation criteria and their proportion was expressed per 1,000 women to apply to the model and to delineate the ecology curve. The perinatal mortality was compared by Chi-square test.
  
  
  RESULTS
  We found remarkable similarity in ecology curves between the original ecology models and that representing Miyazaki perinatal data. However, the curve representing Tokyo was different from the original one. Besides, the perinatal mortality was significantly lower in Miyazaki (4.40/1,000) than in Tokyo (5.06/1,000).
  
  
  CONCLUSIONS
  Applying the ecology model to perinatal care is useful with improvement of perinatal outcome and it would provide an appropriate framework for organizing perinatal care.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
authors.forename: Syuichi
authors.initials: S
authors.lastname: Tokunaga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sameshima
authors.forename: Tsuyomu
authors.initials: T
authors.lastname: Ikenoue
mesh_terms: D016009:Chi-Square Distribution; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006782:Hospitals, Special / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008962:Models, Theoretical; D009774:Obstetrics; D018743:Perinatal Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D054238:Perinatal Mortality; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011320:Primary Health Care / Q000706:statistics & numerical data; D018570:Risk Assessment; D063127:Secondary Health Care / Q000706:statistics & numerical data; D063128:Tertiary Health Care / Q000706:statistics & numerical data