Monitoring health care

Health risk determinants in obstetrics and gynecology are readily obtainable from state birth records. This study demonstrates the manner in which these determinants may be used to assess health care delivery and monitor its progress. The over-all problem is quite complex. Some parameters are interrelated, while others are not. In addition, any specific parameter may be causally related to many different antecedents, acting singly or in combination. Hence, one must take care not to generalize about deficiencies in our health care systems and thereby propose simplistic, unworkable solutions. However, the study does clearly identify certain specific areas of risk which deserve greater attention than they have hitherto received from health care officials, physicians, and responsible citizens. We believe that the approach outlined in this paper offers a means to achieve unbiased, ongoing monitoring of health care, which may, in turn, be used in attempts to improve the delivery of health services.