State Policies and Regional Neonatal
Care: Progress and Challenges 25 Years After TIOP. November, 2001
Regional referral systems that direct high-risk
patients to tertiary level neonatal intensive care units (NICUs) improve neonatal survival. But regionalized neonatal
care systems face increasing stress in health care systems shaped by managed care and hospital networks. Debates about regionalization
have occasionally burst into the public arena, as communities dispute the addition of new NICUs, or state legislatures consider
modifying laws or regulations related to NICUs.
This is the first recent study to assess regionalization
across all the states, and to ask knowledgeable observers across the U.S. about what is driving change. The study answers two questions, based on a comprehensive survey of state health
departments, and on the literature:
• What are state policies regarding
how regional perinatal systems operate?
• What
is changing, and why?
