Is outcome for general practitioner obstetricians influenced by workload and locality? 1988

M W Tilyard, and S Williams, and R J Seddon, and M E Oakley, and C J Murdoch
Department of General Practice, University of Otago Medical School, Dunedin.

Maternal and perinatal morbidity and transfer patterns were examined to assess the influence of the number of deliveries performed by each general practitioner obstetrician and the distance from specialist care. There were statistically significant differences in transfer patterns between urban and rural practitioners and between those practitioners delivering fewer than twenty per year and those delivering twenty or more per year. Antenatally, rural practitioners transferred more of their patients to the base hospital and those practitioners delivering fewer than twenty per year had higher transfer rates than those delivering twenty or more per year. During labour the transfer rate was lowest for rural practitioners delivering more than 20 babies per year. Urban practitioners in comparison to rural practitioners delivered a significantly greater proportion of women who were considered to have a moderate or high obstetric risk. No association was found between the number of deliveries undertaken by general practitioners both urban and rural and maternal and neonatal morbidity. The proportion of women and neonates who had a score which indicated a less favourable outcome for maternal and neonatal morbidity, was higher for urban practitioners than for rural practitioners.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007743 Labor, Obstetric The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED). Obstetric Labor
D008962 Models, Theoretical Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment. Experimental Model,Experimental Models,Mathematical Model,Model, Experimental,Models (Theoretical),Models, Experimental,Models, Theoretic,Theoretical Study,Mathematical Models,Model (Theoretical),Model, Mathematical,Model, Theoretical,Models, Mathematical,Studies, Theoretical,Study, Theoretical,Theoretical Model,Theoretical Models,Theoretical Studies
D009520 New Zealand A group of islands in the southwest Pacific. Its capital is Wellington. It was discovered by the Dutch explorer Abel Tasman in 1642 and circumnavigated by Cook in 1769. Colonized in 1840 by the New Zealand Company, it became a British crown colony in 1840 until 1907 when colonial status was terminated. New Zealand is a partly anglicized form of the original Dutch name Nieuw Zeeland, new sea land, possibly with reference to the Dutch province of Zeeland. (From Webster's New Geographical Dictionary, 1988, p842 & Room, Brewer's Dictionary of Names, 1992, p378)
D009774 Obstetrics A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.
D010821 Physicians, Family Those physicians who have completed the education requirements specified by the American Academy of Family Physicians. Family Physician,Family Physicians,Physician, Family
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011256 Pregnancy Outcome Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; or SPONTANEOUS ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO. Outcome, Pregnancy,Outcomes, Pregnancy,Pregnancy Outcomes
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D005260 Female Females

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