ArticleHealth affairs (Project Hope)2014
Lessons for providers and hospitals from Philadelphia's obstetric services closures and consolidations, 1997-2012.
Article in Health affairs (Project Hope), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Risk Factors for Loss of Hospital-Based Obstetric Care in Rural and Urban Hospitals.JAMA health forum · 2026Article
- Article
- The Impact of Hospital Delivery Volumes of Newborns Born Very Preterm on Mortality and Morbidity.The Journal of pediatrics · 2025Observational
- Severe Maternal Morbidity and Maternal Mortality in Women With Intellectual and Developmental Disabilities.American journal of preventive medicine · 2021Article
- Using the Ecological Systems Theory to Understand Black/White Disparities in Maternal Morbidity and Mortality in the United States.Journal of racial and ethnic health disparities · 2021Review
- Spontaneous vaginal birth varies significantly across US hospitals.Birth (Berkeley, Calif.) · 2021Article
- Assuring safe patient care in a level III NICU in anticipation of hospital closure.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
- Comparison of state risk-appropriate neonatal care policies with the 2012 AAP policy statement.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
- Safety of labour and delivery following closures of obstetric services in small community hospitals.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Article
- Article
- Impacts of Health Care Industry Consolidation in Pittsburgh, Pennsylvania: A Qualitative Study.Inquiry : a journal of medical care organization, provision and financingArticle
- Maternity Care Deserts and Pregnancy-Associated Mortality in Louisiana.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
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Authors and funding
5 authors.
Funding
Abstract
The Affordable Care Act is triggering an increase in hospital consolidation and mergers. How other hospitals respond to these disruptions in supply could influence patient outcomes. We examined the experience of Philadelphia County, Pennsylvania (coterminous with the city of Philadelphia), where thirteen of nineteen hospital obstetric units closed between 1997 and 2012. Between October 2011 and January 2012 we interviewed twenty-three key informants from eleven hospitals (six urban and five suburban) whose obstetric units remained open, to understand how the large number of closures affected their operations. Informants reported having confronted numerous challenges as a result of the obstetric unit closures, including sharp surges in delivery volume and an increase in the proportion of patients with public insurance or no insurance. Informants reported adopting a number of strategies, such as innovative staffing models, to cope with the added demand brought about by the closure of nearby obstetric units. Informants emphasized that interhospital communication could mitigate closures' stresses on the health care system. Our study supports the need for policy makers to anticipate reductions in supply and monitor patient outcomes.
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