The Influence of Hospital Closures in Nova Scotia on Perinatal Outcomes

摘要: Abstract Objective : To evaluate the effect of hospital closures on critical obstetrical interventions and perinatal outcomes in rural communities Nova Scotia, Canada. Methods A population-based cohort study was carried out for years 1988 to 2002, using data extracted from Scotia Atlee Perinatal Database. Regions maternal residence were defined geographically administratively as Eastern, Northern, Western, Central. The time periods 1993 1996 2002 chosen based timing closures. Changes rates several examined by region relation extent experienced that region. Results majority occurred 1994 1995 with establishment new health regions, affected Western most profoundly. In comparison Central (relative risk [RR], 0.56; 95% confidence interval [Cl], 0.53–0.59), temporal reduction rate forceps-assisted vaginal delivery smaller (RR, 0.83; Cl, 0.76–0.91; P Conclusion Although trends over demonstrated sorne regional differences outcomes, our retrospective evaluation did not reveal a consistent relationship between reductions maternity services associated systematic, population-level adverse consequences Scotia.