Vital statistics data as a measurement of perinatal regionalization in Alabama, 1970 and 1980

Although regionalization of perinatal health care services has received credit for much of the recent improvement in neonatal mortality, until now no measurement of regionalization has been proposed. The measurement presented in this paper--the average of the percentage of infants of very low birthweight and neonatal deaths occurring among residents of a geographic area at a perinatal center--provides a means of comparing the extent of perinatal regionalization in various geographic areas and time periods. Despite continued disparities in the degree of regionalization from one perinatal district to another, Alabama's perinatal system became substantially regionalized from 1970 to 1980. The lower mortality for infants of very low birthweight born at a perinatal center suggests that if Alabama were more completely regionalized, its neonatal mortality would be improved.