Abstract
ABSTRACT: The nursery and labor/delivery unit have long been loss leaders in hospital accounting. However, Medicaid, Crippled (or Handicapped) Children's Services, Blue Cross and Blue Shield will make very high payments for intensive fetal and neonatal care. As a result, there was an increase of 18% in the number of neonatal intensive care units (NICUs) between 1977 and 1978, and a concomitant reduction in newborn nursery space. Because a large number of NICU beds, and a 75% occupancy rate, are required by local and professional standards, in order to fill NICU beds normal or very mildly sick full‐term newborns are being admitted. The number of tests and treatments were found to be lowest after rotation of residents in August, and to increase monthly until they rotated out in June. Of full‐term newborns, 18% were treated for jaundice and/or given septic work‐ups at one Level II hospital. At another, the same percent of babies was admitted to the NICU from the alternative birth center (ABC) as from the labor/delivery unit, despite figures indicating that the ABC babies had better outcomes on all parameters.
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