title: 'The Best Health Care Delivery System in the World'? Women's health and maternity/newborn care trends in Philadelphia, PA, United States-1997-2011: a case report.
abstract: Despite being ranked number one globally in terms of health care cost per capita, the United States (US) has ranked as low as 37th in the world in terms of health care system performance. This poor performance for one of the most developed nations in the world has been reflected in the underachieved attempts of the multiple US health care systems at improving maternal and newborn health, according to the goals set in 2000 by the United Nations with Millennium Development Goals (MDG's) 5: Improve Maternal Health, and 4: Reduce Child Mortality. This paper will examine the progress, or lack thereof, over a period of 15 years of the fifth largest urban area in the US - Philadelphia, Pennsylvania - in its delivery of health care to pregnant women and their newborns. Using data collected from national, state, and city health agencies, trends concerning pregnancy care will be presented and compared to the target goals of MDG-5 and MDG-4, as well as Healthy People 2020, a US government-based initiative to improve health care of all Americans. Findings will demonstrate that urban areas such as Philadelphia are on a path of not reaching goals that have been set by the United Nations and the US government, and by some indicators are moving away in a negative direction from these goals.
authors.affiliation: Midwifery Graduate Program, University of Pennsylvania School of Nursing, Philadelphia, PA, USA. Electronic address: mccoolwf@nursing.upenn.edu.
authors.forename: William F
authors.initials: WF
authors.lastname: McCool
authors.forename: Mamie
authors.initials: M
authors.lastname: Guidera
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Janis
mesh_terms: D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards / Q000639:trends; D036861:Delivery, Obstetric / Q000191:economics / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000379:methods / Q000458:organization & administration / Q000639:trends; D008428:Maternal Mortality / Q000639:trends; D020380:Needs Assessment; D015143:Philadelphia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care / Q000379:methods / Q000458:organization & administration / Q000639:trends; D012959:Socioeconomic Factors; D016387:Women's Health
keywords: MDG-5 and MDG-4; Pregnancy; United States; Urban