Although regionalization of hospital health care has occurred, regionalization of perinatal care has declined. Earlier studies suggested that delivery at a high-volume, high-technology hospital reduced neonatal mortality, but little information is available on the effect of delivery hospital on other outcomes. This retrospective population-based cohort study examined all hospital-based deliveries in Pennsylvania, California, and Missouri to obtain unbiased measurements of the impact on mortality of delivering at high-volume, high-level neonatal intensive care units (NICUs) and compared non-NICU hospitals in these states with different systems of regionalization and different patient populations to examine common complications of premature birth.
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