RT Journal Article
SR Electronic
T1 Relation Of Infant Mortality To The Availability Of Maternity Care In Rural Florida
JF The Journal of the American Board of Family
                Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 392
OP 399
DO 10.3122/jabfm.8.5.392
VO 8
IS 5
A1 Larimore, Walter L.
A1 Davis, Alan
YR 1995
UL http://www.jabfm.org/content/8/5/392.abstract
AB Background: This cross-sectional study was designed to explore the impact of the availability of maternity care services on the infant mortality rates in nonmetropolitan (rural) counties in Florida. Methods: We evaluated the sufficiency of physicians providing maternity care in each rural county. We then constructed a mathematical model to compare physician availability with the infant mortality rates for each county, while controlling for socioeconomic variables. Results: Thirty-one family physicians and 974 obstetrician-gynecologists were delivering babies in Florida in 1991. Forty-seven counties were lacking in maternity care services; 45 of these counties had family physicians who practiced in the county but did not provide maternity care services. There was a negative correlation in rural counties between availability of maternity care services and infant mortality (R = −0.42, R2 = 0.176, P= 0.012), implying that 17.6 percent of the variation in rural Florida's infant mortality was explained by a ranking in physician availability. Multivariate analysis revealed that increasing infant death rates can be predicted by decreasing physician availability (P = 0.003). A multiplicative risk model developed for this study demonstrated that the loss of 1 family physician delivering babies would predict the increase of infant mortality by 2.3 percent, and the loss of 1 obstetrician-gynecologist increased infant mortality by 9.6 percent. Conclusions: Access to maternity care for women in rural Florida is a problem that could be hampering Florida's ability to reduce its infant mortality rate. Family physicians appear to be the most geographically distributed health care providers in Florida; therefore, strategies should be developed to recruit Florida's rural family physicians into maternity care.