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Efficacy of Regionalization of Perinatal/Neonatal Care

Alan D. Bedrick, MD
Am J Dis Child. 1987;141(10):1038. doi:10.1001/archpedi.1987.04460100016003.
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Sir.—I read the recent editorial by Kanto1 concerning the lost efficacy of regionalized perinatal/neonatal care. I strongly disagree with his opinion that regionalization has deteriorated into "turf guarding." Only with regionalization has there been significant improvement in neonatal mortality and morbidity trends in many states. The concept must not be discarded but subjected to continued refinement and modification as complex economic and political influences come into play. I agree with Dr Kanto that hospital administrators and professional staffs should "describe the type of patients who would be provided care in that particular perinatal unit." However, these services must be monitored closely. It is not economical or safe for neonates that hospital staffs be permitted to arbitrarily decide what type of neonatal care they should provide. Is it safe for a hospital to maintain a complete spectrum of highly skilled personnel and expensive equipment to perform ventilation on a

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