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

That’s in keeping with an article in JAMA based mostly on a report from the Heart for Healthcare High quality and Fee 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 underneath 20 minutes, however in rural areas, the journey time is more likely to be no less than half-hour, and it’s usually 40 minutes or extra.

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

The longer journey distances impression not solely entry to care throughout supply, but additionally 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 more likely to acquire enough 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 stated. “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 will’t take break day of labor, can’t take time away from the children.”

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

Why are rural hospitals dropping maternity care? Clearly the reply is that reimbursement is way beneath their price. Furthermore, discovering enough staffing is troublesome.

Sustaining labor and supply providers requires having physicians and nurses, together with nurse anesthetists or anesthesiologists, who’re skilled and obtainable across the clock to handle deliveries as wanted. Consequently, funds per start which might be enough at a big hospital are usually not sufficient to help maternity care at small rural hospitals with far fewer births.
“We ship about 300 infants a yr, so a median of lower than 1 a day, however you continue to must have OB-GYN protection three hundred and sixty five days a yr, 24 hours a day, 7 days per week as a result of infants come always,” Sinek stated in an interview. “It’s costing us $7.5 million proper now to workers our OB unit with nurses that know what they’re doing and CRNAs [certified registered nurse anesthetists] to do anesthesia providers and the workplace workers to help that care. All of that’s actually including up, and for those who 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 prepared to be on name a number of nights and weekends out of each month…Consequently, hospitals both should make use of or contract with extra physicians or OB-GYN hospitalists.

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

You possibly can learn the complete report right here.