55% of US Rural Hospitals Are No Longer Supply Birthing Providers – Healthcare Economist

That’s in accordance with an article in JAMA based mostly on a report from the Heart for Healthcare High quality and Cost Reform. The report states:

Greater than half (55%) of the agricultural hospitals within the U.S. don’t provide labor and supply providers, and in 10 states, greater than two-thirds don’t. Over the previous decade, greater than 200 rural hospitals throughout the nation have stopped delivering infants…

In most city areas, the journey time to a hospital with labor and supply providers is below 20 minutes, however in rural areas, the journey time is prone to be at the least half-hour, and it’s usually 40 minutes or extra.

https://ruralhospitals.chqpr.org/downloads/Rural_Maternity_Care_Crisis.pdf

The longer journey distances affect not solely entry to care throughout supply, but in addition prenatal and post-natal care.

The absence of native maternity care providers is felt all through the continuum of obstetric care. Sufferers are much less prone to acquire ample prenatal or postpartum care providers if they should journey lengthy distances.

“It’s one factor to say the mom has to drive half an hour to ship her child,” Miller mentioned. “It’s one other factor to say the mom has to drive a half an hour each month to have the ability to get prenatal care. They’ll’t take day without work of labor, can’t take time away from the youngsters.”

https://jamanetwork.com/journals/jama/fullarticle/2815499

Why are rural hospitals dropping maternity care? Clearly the reply is that reimbursement is much under their price. Furthermore, discovering ample staffing is tough.

Sustaining labor and supply providers requires having physicians and nurses, together with nurse anesthetists or anesthesiologists, who’re educated and accessible across the clock to handle deliveries as wanted. In consequence, funds per delivery which are ample at a big hospital will not be sufficient to assist maternity care at small rural hospitals with far fewer births.
“We ship about 300 infants a yr, so a mean of lower than 1 a day, however you continue to must have OB-GYN protection 12 months a yr, 24 hours a day, 7 days per week as a result of infants come always,” Sinek mentioned in an interview. “It’s costing us $7.5 million proper now to employees our OB unit with nurses that know what they’re doing and CRNAs [certified registered nurse anesthetists] to do anesthesia providers and the workplace employees to assist that care. All of that’s actually including up, and if you happen to don’t ship sufficient infants to cowl these prices, then you definately’re on a downhill course.”

…fewer obstetricians and household physicians with obstetric abilities are in a position or keen to be on name a number of nights and weekends out of each month…In consequence, hospitals both should make use of or contract with extra physicians or OB-GYN hospitalists.

https://jamanetwork.com/journals/jama/fullarticle/2815499

You’ll be able to learn the complete report right here.