Hospitals are under significant pressure from payers to reduce costs. The single largest fixed cost for a hospital is inpatient beds, yet there is significant variation in hospital capacity utilization. We study bed capacity in New York City hospital obstetrics units and find that while many hospitals have an insufficient number of beds to provide timely access to care, overall there is significant excess capacity. Our findings, coupled with current demographic and clinical practice trends, indicate that a large fraction of obstetrics units nationwide could likely reduce their bed capacity while assuring timely access to care, resulting in large savings in capital and staffing costs. Given emerging health care delivery and payment models that will likely decrease demand for other types of hospital beds, our study suggests that data-based methodologies should be used by hospitals and policy makers to identify opportunities for reducing excess bed capacity in other inpatient units as well.
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http://dx.doi.org/10.1177/1077558715572388 | DOI Listing |
Reprod Health
January 2025
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Background: Over one-third of the global stillbirth burden occurs in countries affected by conflict or a humanitarian crisis, including Afghanistan. Stillbirth rates in Afghanistan remained high in 2021 at over 26 per 1000 births. Stillbirths have devastating physical, psycho-social and economic impacts on women, families and healthcare providers.
View Article and Find Full Text PDFImplement Sci Commun
January 2025
Department of Obstetrics and Gynecology, University of Michigan, 2800 Plymouth Rd., Building #10, Rm G016, Ann Arbor, MI, 48109-5276, USA.
Background: Pain management after childbirth is widely variable, increasing risk of untreated pain, opioid harms, and inequitable experiences of care. The Creating Optimal Pain Management FOR Tailoring Care (COMFORT) clinical practice guideline (CPG) seeks to promote evidence-based, equitable acute peripartum pain management in the United States. We aimed to identify contextual conditions (i.
View Article and Find Full Text PDFPlacenta
December 2024
Department of Obstetrics and Gynecology, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, the Netherlands; Eindhoven MedTech Innovation Center (e/MTIC), P.O. Box 513, 5600 MB, Eindhoven, the Netherlands.
Introduction: The postpartum period can be complicated by hemorrhage, frequently caused by uterine atony. Electrohysterography, allowing continuous monitoring of uterine activity, may be a promising alternative for early detection of uterine atony, and thereby contribute to the prevention of postpartum hemorrhage. Associations between electrohysterographic parameters postpartum and total blood loss were studied.
View Article and Find Full Text PDFWest Afr J Med
August 2024
Department of Haematology and Immunology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria.
Background: There are reports of a high prevalence of maternal peripheral and placental malarial parasitaemia (MP) in southeastern Nigeria following the two-dose regimen of sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment (IPT) of malaria in pregnancy.
Objective: To compare the effectiveness of monthly versus two-dose regimens of SP for IPT of malaria in pregnancy in Enugu, south-eastern Nigeria.
Methods: A randomized controlled trial involving antenatal clinic attendees at the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria.
Am J Perinatol
December 2024
Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn.
Objective: In recent years, the management of placenta accreta spectrum (PAS) has fallen into two categories: planned hysterectomy and conservative management to preserve fertility. However, optimal management remains unclear. Therefore, we conducted a systematic review and meta-analysis comparing the two to evaluate which approach was associated with lower surgical morbidity.
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