Change in Oregon maternity care workforce after malpractice premium subsidy implementation. Health Serv Res 2009 Aug;44(4):1253-70
Date
06/09/2009Pubmed ID
19500166Pubmed Central ID
PMC2739027DOI
10.1111/j.1475-6773.2009.00984.xScopus ID
2-s2.0-68349100068 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
OBJECTIVES: (1) To determine the proportion of maternity care providers who continue to deliver babies in Oregon; (2) to determine the important factors relating to the decision to discontinue maternity care services; and (3) to examine how the rural liability subsidy is affecting rural maternity care providers' ability to provide maternity care services.
STUDY DESIGN: We surveyed all obstetrical care providers in Oregon in 2002 and 2006. Survey data, supplemented with state administrative data, were analyzed for changes in provision of maternity care, reasons for stopping maternity care, and effect of the malpractice premium subsidy on practice.
PRINCIPAL FINDINGS: Only 36.6% of responding clinicians qualified to deliver babies were actually providing maternity care in Oregon in 2006, significantly lower than the proportion (47.8%) found in 2002. Cost of malpractice premiums remains the most frequently cited reason for stopping maternity care, followed by lifestyle issues. Receipt of the malpractice subsidy was not associated with continuing any maternity services.
CONCLUSIONS: Oregon continues to lose maternity care providers. A state program subsidizing the liability premiums of rural maternity care providers does not appear effective at keeping rural providers delivering babies. Other policies to encourage continuation of maternity care need to be considered.
Author List
Smits AK, King VJ, Rdesinski RE, Dodson LG, Saultz JWAuthor
Lisa Grill Dodson MD Campus Dean, Professor in the Medical School Regional Campuses department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Attitude of Health PersonnelFamily Practice
Female
Financing, Government
Health Care Surveys
Humans
Insurance Coverage
Insurance, Liability
Male
Malpractice
Midwifery
Obstetrics
Oregon
Practice Patterns, Physicians'
Rural Health Services
