获得有利于分娩的产妇护理设施

美国可预防的孕产妇死亡率.S. 已经大幅增长并促使联邦政府采取行动, 最明显的是随着发展 白宫解决孕产妇健康危机蓝图(PDF). Growing disparities in maternal mortality and morbidity adversely affecting persons of color and under-resourced or marginalized populations accentuate this crisis.

CMS分娩友好称号

As part of ongoing efforts to improve maternal health, the Centers for Medicare & Medicaid 服务 (CMS) has begun to assign a “生育-friendly” designation to identify facilities that participate in a state or national perinatal quality improvement collaborative and implement patient safety practices or bundles as part of these initiatives. 通过指定分娩友好医院和, 通过这个, 表明在孕产妇保健中一贯采用循证做法, CMS hopes to increase and further ensure access to high-quality perinatal services and help expectant parents find the quality care they want and deserve.

获得高质量孕产妇保健的机会差别很大

Recent analysis of CMS 生育-friendly designation data by 趣赢平台 finds the proportion of facilities within a state that CMS currently designates as 生育-friendly varies considerably. 目前有16个州拥有超过80%的 生育 被指定为分娩友好型的设施有6个不到40%. States where 生育-friendly designated facilities reach more than 80% are primarily located in the eastern portion of the country with California and New Mexico being exceptions. States with fewer than 40% of facilities designated as 生育-friendly are in the Midwest and Northwest and have high concentrations of rural counties. 这些县更有可能成为“产妇护理沙漠”,的特点是缺乏产妇护理资源和, 因此, 获得高质量产科护理的机会不均衡. Most states can boast that at least half their facilities are designated as 生育-friendly. 参见图1.

图1图像描述

用最佳做法改变护理

通过最近宣布的孕产妇保健转型模式, CMS hopes to encourage greater use of maternal care quality improvement/patient safety bundles and other established best practices. Patient safety bundles are well-established and are one approach supported by the 产妇保健创新联盟，几乎所有的州都参加了. The association between the proportion of 生育-friendly designated hospitals and states’ initial AIM participation is one indication that CMS’s objectives for TMaH are a step forward. 各州开始AIM的时间越早, the more likely they are to have at least 60% of hospitals designated as 生育-friendly. 具体地说, 在2019年或更早开始参与AIM的国家中, 89% have at least 60% of their facilities designated as 生育-friendly while only half of states that began AIM in 2020 or later can make the same claim. 参见图2.

图2图像描述

Variation in the proportion of facilities designated as 生育-friendly across the country underscores the stark reality of disparities in perinatal care. Hospitals in several states with high concentrations of rural areas are much less likely to be designated as 生育-friendly, 给当地居民留下的高质量选择越来越少. The anticipated TMaH Model can support hospitals that seek to achieve this designation to catalyze improved maternity care. 在TMaH之前, CMS may consider prioritizing outreach to states that lack established programs or resources to implement patient safety bundles and require the most support, and identify lessons learned from states with high proportions of 生育-friendly facilities.

Submitted by 多明尼克埃斯波西托, PhD, a 副总统 for 行为健康 and Health Policy. Hollie哈萨尼, 英里每小时, 社会政策和经济研究高级研究员, 制作了这里展示的地图.