Perinatal regionalization (PR) is one of several solutions proposed to increase access to quality care and improve infant health outcomes. PR, a systems approach to coordinating healthcare services to ensure mothers and babies receive the care they need, has been recognized as a best practice for improving maternal and infant outcomes over the past several decades. However, over time, several factors have threatened the viability of PR systems across the country. Currently, many states in the U.S. working to improve outcomes are revisiting efforts to develop formalized PR. Hence, there is a need to better understand practices and policies surrounding the development, implementation, and sustainability of PR systems. Through the examination of stakeholders’ perceptions and professional experiences, this qualitative instrumental case study of PR in Michigan investigates Michigan’s long history with PR and its current efforts to reestablish PR in the state. Twelve key informant interviews were conducted with healthcare administrators, maternal and child health advocates, public health officials, and policymaker stakeholders. These in-depth interviews yielded data from which the following five overarching themes emerged to describe the evolution of Michigan’s PR system and factors that may contribute to an effective PR system in the state today: PR evolution, outcomes, contextual factors, mitigating factors, and sustainability. This study provides comprehensive insights into stakeholders’ perceptions of PR efforts in Michigan. Results from this study will inform other states aiming to advance favorable maternal and child health outcomes through regionalized perinatal care.
|Commitee:||Frasso, Rosemary, Klaiman, Tamar, Keddem, Shimrit|
|School:||University of the Sciences in Philadelphia|
|School Location:||United States -- Pennsylvania|
|Source:||DAI-B 81/10(E), Dissertation Abstracts International|
|Subjects:||Public health, Health care management|
|Keywords:||Health services research, Infant mortality, Michigan, Perinatal regionalization, Preterm birth, Quality|
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