Dartmouth Medical School professors study the uneven landscapeof newborn intensive care services: Variation in the neonatology workforce

Hanover, NH A team of Dartmouth Medical School researchers has completed the first study of the neonatal workforce since 1983 to determine the geographic distribution of neonatologists in the United Sates. Their results, reported in the July/August issue of Effective Clinical Practice, lay the groundwork for understanding whether neonatal intensive care resources are located in accordance with risk and whether more resources improve newborn outcomes.

In the past 30 years, the number of neonatologists has increased while total births have remained nearly constant. It is not known how equitably this workforce is distributed. The Dartmouth Medical School researchers -- David C. Goodman, MD, MS; Elliot S. Fisher, MD, MPH; George A. Little, MD; Therese A. Stukel, PhD; and Chaing-Hua Chang, MS -- set out to determine the geographic distribution of neonatalogists in the United States.

"Despite rapid growth in neonatal intensive care, there is little information about whether services tend to be located where newborn needs are greatest, and whether more resources always lead to better outcomes," said Goodman. "This study finds a very high degree of regional variation for neonatal intensive care; studies are underway to understand how well this distribution serves newborns."

Neonatal intensive care, considered one of the most important recent advances in pediatrics, has been shown to be highly effective in reducing mortality and improving long-term outcomes for premature and ill newborns. The Dartmouth team found that the regional supply of neonatologists varies dramatically and cannot be explained by the substitution of neonatal mid-level providers or by the proximity of academic medical centers.

The team measured the number of neonatologists and neonatal mid-level providers per live birth within 246 market-based regions. They found that the neonatology workforce varied substantially across neonatal intensive care regions. The number of neonatologi

Contact: Stephen Snyder
Dartmouth Medical School

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