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The Status of Obstetrics Access
14 OB units have closed since 1997 in Southeastern Pennsylvania
Closing obstetric units (OB units) have contributed to local spikes in occupancy rates and raised concerns around the capacity of remaining units to serve women safely. Women also face an additional barrier because their provider may not accept their insurance plan.
Closing OB Units
There is an alarming trend of diminishing birthing options for pregnant women in Southeastern Pennsylvania.
UNIT/HOSPITAL CLOSED(Southeastern PA)
Bucks
Warminster (2000)
Delaware
Mercy Fitzgerald (2003)
Montgomery
Elkins Park (2001)
Philadelphia
Medical College of
Pennsylvania (1997)
Nazareth (1998)
Germantown (1998)
City Avenue (1999)
Roxborough (1999)
Episcopal (2001)
Mercy Philadelphia (2002)
Methodist (2002)
Parkview (2003)
Frankford (2006)
Jeanes (2007)
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UNIT/HOSPITAL STILL OPEN
June 2008
(Southeastern PA)
Bucks
Doylestown Hospital
Grand View Hospital
Lower Bucks Hospital
St. Mary Medical Center
Chester
Brandywine Hospital
Chester County Hospital
Jennersville Regional Hospital
Paoli Hospital
Phoenixville Hospital
Delaware
Crozer-Chester Medical Center
Delaware County Memorial Hospital
Riddle Memorial Hospital
Montgomery
Abington Memorial Hospital
Bryn Mawr Hospital
Central Montgomery Medical Center
Holy Redeemer Health System
Lankenau Hospital
Mercy Suburban Hospital Montgomery Hospital Medical Center
Pottstown Memorial Medical Center
Philadelphia
Albert Einstein Medical Center
Chestnut Hill HealthCare
Hahnemann University Hospital
Hospital of the University of
Pennsylvania
Pennsylvania Hospital
Temple East-Northeastern Hospital
Temple University Hospital
Thomas Jefferson University
Hospital
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BIRTH CENTERS OPEN
Bryn Mawr Birth
Center
Valley Birthplace &
Woman Care
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Capacity Concerns for OB Units
OB Unit Capacity charts show the occupancy rate in 1996 compared to 2006 for Bucks, Chester, Delaware, Montgomery and Philadelphia counties. Capacity is an area of concern for practitioners and families. The literature, discussed briefly below, recommends a capacity around 75% and, in 2006, 4 of the 8 remaining OB units in Philadelphia were operating above this capacity; one at 107.5% (Table 13)!
Furthermore, anecdotal evidence suggests that OB practitioners and hospital staff are overwhelmed and patients are frustrated about overcrowded facilities and traveling further distances to receive care.
The Philadelphia Department of Public Health commissioned a Drexel University report, "Obstetric Care for Philadelphia Residents: 1997-2004." The following is an excerpt:
Individual hospitals make their own determinations as to what occupancy level they are comfortable with, taking into account fiscal pressures, risk, and provider workload. Several states and organizations have published “ideal” obstetric occupancy rates, sometimes varying for urban and rural areas or small vs. large hospitals.
Table 13:
Industry Recommendations for Obstetric Unit Occupancy Rate
(see citations below) |
Source |
Recommendation for obstetric occupancy |
NY State Department of Health |
75% in an urban area |
Virginia (Certificate of Need) |
80% |
Illinois Health Facilities Planning Board |
75% for hospitals with 11-25 beds
78% for hospitals with 26 or more beds |
Department of Defense |
70% |
American College of Obstetrics and Gynecology |
75% |
NICU occupancy target |
75% |
Table 13 citations:
New York State Department of Health: Acute Care Facilities
Illinois Health Facilities Planning Board (03/21/2005)
Department of Defense Planning Criteria for Health Facilities
"Strategies for Cutting Hospital Beds: The impact on patient services"
Excerpt courtesy of report author:
Jennifer Kolker, MPH
Assistant Professor
Drexel University School of Public Health Department of Health Management and Policy
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Last Updated June 2008 |
