PEDIATRICS Vol. 65 No. 5 May 1980, pp. 910-916
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Regional Neonatal Transport: Impact of an Integrated Community/Center System

James Sumners MD1, Howard B. Harris MD1, Bobbetta Jones BS1, George Cassady MD1, and David D. Wirtschafter MD1

1 Division of Perinatal Medicine, Department of Pediatrics and Clinical Information Systems, University of Alabama School of Medicine, Birmingham

In the face of increasing neonatal referrals from a large geographic region, community hospital resources were recruited and coordinated with regional center resources to facilitate "community-based" neonatal transport. All transport requests were first "triaged" by an attending neonatologist. Discriminant analysis was used to assess the impact of resource allocation decisions. Decisions regarding allocation of resources to an individual transport generally reflected geographic distance to be traveled, size of delivery service at referring hospital, and apparent degree of illness. Physicians participation in transports was reduced from 95% to 15% of the trips. The incorporation of community-based transport resources and nonphysician transport teams into a coordinated triage and transport process with existing center-based resources did not adversely affect neonatal survival. Capacity of the transport system was enhanced with these reallocations.

Submitted on January 31, 1979
Accepted on August 23, 1979