State Policies and Regional Neonatal Care: Progress and Challenges 25 Years After TIOP.
Regional referral systems that direct high-risk patients to tertiary level neonatal intensive care units (NICUs) improve neonatal survival. But regionalized neonatal care systems face increasing stress in health care systems shaped by managed care and hospital networks. Debates about regionalization have occasionally burst into the public arena, as communities dispute the addition of new NICUs, or state legislatures consider modifying laws or regulations related to NICUs.
This is the first recent study to assess regionalization across all the states, and to ask knowledgeable observers across the U.S. about what is driving change. The study answers two questions, based on a comprehensive survey of state health departments, and on the literature:
- What are state policies regarding how regional perinatal systems operate?
- What is changing, and why?