ArticleFrontiers in global women's health2023
Consolidation of the perinatal care system and workload of obstetricians: an ecological study in Japan.
Article in Frontiers in global women's health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Midwife-Led Home Births in Japan: A 25-Year Retrospective Analysis of Care in Accordance with WHO Recommendations Before and After COVID-19.Healthcare (Basel, Switzerland) · 2026Article
- Nationwide Comparison of ICU Procedure Frequencies in Japan Using a Public Open Database: A Cross-Sectional Study by ICU Admission Fee Type and Region.Journal of clinical medicine · 2026Article
- Trends and determinants of acute tocolysis implementation in Japan, 2012-2023: An 11-year nationwide retrospective cohort study.PloS one · 2026Article
- Article
- Hysterectomy for postpartum hemorrhage in Japan: Diagnostic code validation and nationwide descriptive analysis.The journal of obstetrics and gynaecology research · 2025Article
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4 authors.
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Abstract
Objectives: We examined the relationship between consolidation of delivery and the workload of obstetricians working at perinatal centers. Methods: We conducted a descriptive analysis using perinatal care areas classified into three types (metropolitan, provincial, and rural). We calculated the Herfindahl-Hirschman Index (HHI) as an index of consolidation and the proportion of the deliveries at clinics as an indicator of the low-risk deliveries and the deliveries per center obstetrician as an indicator of obstetricians' workload. We used >150 deliveries yearly as an excess indicator. The correlation between the HHI and obstetricians' workload and the proportion of deliveries at clinics was examined using the Pearson correlation coefficient. Results: The proportion of areas with >150 deliveries yearly was higher in the consolidated areas. In provincial areas, obstetricians' workload was positively correlated with the HHI and was negatively correlated with the proportion of deliveries at clinics. Conclusions: The obstetricians' workload may be increasing where more consolidation occurs. In provincial areas, the center obstetrician's workload could be reduced not only by consolidation but also by sharing the role of handling low-risk deliveries with clinics and hospitals with obstetric units other than perinatal centers.
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