Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities

PURPOSE: The purpose of this study was to describe the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals. METHODS: We con...

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Vydané v:	The Journal of rural health Ročník 31; číslo 4; s. 365 - 372
Hlavní autori:	Kozhimannil, Katy B., Casey, Michelle M., Hung, Peiyin, Han, Xinxin, Prasad, Shailendra, Moscovice, Ira S.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	England Journal of Rural Health 01.09.2015 Blackwell Publishing Ltd Wiley Subscription Services, Inc
Predmet:	access to care Adult Births Censuses Challenges Childbirth & labor Colorado Colorado - epidemiology Delivery, Obstetric - statistics & numerical data education Employment Employment status family medicine Family physicians Female Health care delivery Health services health services research Hospitals Hospitals, Rural - manpower Humans Infants Interdisciplinary aspects Interdisciplinary education Iowa Iowa - epidemiology issues and policy Kentucky Kentucky - epidemiology labor force Maternal Health Services - manpower Medical personnel Medical technology Midwives New York New York - epidemiology North Carolina North Carolina - epidemiology Obstetricians Obstetrics Obstetrics - manpower Oregon Oregon - epidemiology physician supply Physicians Policy making Qualitative analysis Qualitative research Recruitment Rural areas rural health Rural health care Rural Health Services - manpower rural hospitals Rural Population - statistics & numerical data Simulation Socioeconomic Factors Staffing Surgeons surveys Telecommunications Telemedicine Telephone surveys Training Vermont Vermont - epidemiology volume Washington (state) Washington - epidemiology Wisconsin Wisconsin - epidemiology Workforce Workforce planning Young Adult North Carolina Oregon Vermont New York Iowa Colorado Washington (state) Kentucky Wisconsin Washington health services research hospitals family medicine access to care physician supply
ISSN:	0890-765X, 1748-0361, 1748-0361
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Shrnutí:	PURPOSE: The purpose of this study was to describe the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals. METHODS: We conducted a telephone survey of 306 rural hospitals in 9 states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin, from November 2013 to March 2014 to assess their obstetric workforce. Bivariate associations between hospitals’ annual birth volume and obstetric workforce characteristics were examined, as well as qualitative analysis of workforce changes and staffing challenges. FINDINGS: Hospitals with lower birth volume (<240 births per year) are more likely to have family physicians and general surgeons attending deliveries, while those with a higher birth volume more frequently have obstetricians and midwives attending deliveries. Reported staffing challenges include scheduling, training, census fluctuation, recruitment and retention, and intrahospital relationships. CONCLUSIONS: Individual hospitals working in isolation may struggle to address staffing challenges. Federal and state policy makers, regional collaboratives, and health care delivery systems can facilitate solutions through programs such as telehealth, simulation training, and interprofessional education.
Bibliografia:	http://dx.doi.org/10.1111/jrh.12112 istex:E385FAA23658ADFDAAE8D7C1E4FB0258E012EE43 ArticleID:JRH12112 ark:/67375/WNG-9Z9WWJLV-1 Support for this research was provided by the federal Office of Rural Health Policy, Health Resources and Services Administration (PHS Grant No. U1CRH03717). This work was also supported by the Building Interdisciplinary Research Careers in Women's Health Grant (K12HD055887) from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Acknowledgments Funding The authors wish to acknowledge the State Inpatient Databases, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality; our Rural Hospital Obstetric Advisory Group; the rural hospital survey respondents; the Office of Measurement Services at the University of Minnesota, for fielding the survey; and Alex Evenson, MA, for editing assistance. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	0890-765X 1748-0361 1748-0361
DOI:	10.1111/jrh.12112