Texas State Health Plan: 1985, Appendix A Page: 38
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PERINATAL SERVICES
Guidelines 3 and 4 and their resource standards are quoted from CFR 42, Part
121 as follows:
Guidelines #3 - Obstetrical Services
Standards
(1) "Obstetrical services should be planned on a regional basis with linkage
among all obstetrical services and with neonatal services.
(2) Hospitals providing care for complicated obstetrical problems (Levels II
and III) should have at least 1,500 births annually.
(3) There should be an average annual occupancy rate of at least 75% in each
unit with more than 1,500 births per year."
Guideline #4 - Neonatal Special Care Units
Standards
(1) "Neonatal services should be planned on a regional basis with linkages
with obstetrical services.
(2) The total number of neonatal intensive and intermediate care beds should
not exceed 4 per 1,000 live births per year in a defined neonatal service
area. An adjustment upward may be justified when the rate of high-risk
pregnancies is unusually high, based on analyses by the health systems agency.
(3) A single neonatal special care unit (Level II or III) should contain a
minimum of 15 beds. An adjustment downward may be justified for a Level II
unit when travel time to an alternate unit is a serious hardship due to
geographic remoteness, based on analyses by the health systems agency."
Background The above quoted NHPG Resource Standards were discussed in summary
form at the statewide level in Chapter 9 of the SHP. The tables to follow
provide additional data at the health service area (HSA) and the state
planning region (SPR) levels. The information in these tables will allow
preliminary evaluation regarding the availability of perinatal inpatient
services in specific areas throughout the State. These data should provide an
initial focus to the task force recommended in the SHP in its review of
regionalization to support the delivery of perinatal inpatient services.
Additionally, the information should support more definitive local area
analysis, especially as the local organizations/groups which are expected to
become involved in the health planning process, in fact, come on line.
The first step in the development of a regionalized system of perinatal care
services is to determine levels of care for hospital units which provide
services to both mothers and newborns. Formal designation of individual
hospital units in terms of levels of care will enhance the overall design for
regionalization and help encourage the use of the most appropriate level of
care through the proper referral of patients.38
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Texas. Statewide Health Coordinating Council. Texas State Health Plan: 1985, Appendix A, report, 1985; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1586722/m1/182/: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.