{
    "abstract": "The goal of the Rural Surgical and Obstetrical Networks (RSON) of British Columbia was to support safe and appropriate surgery, operative birth, and perinatal care closer to home for rural communities. Family physicians with enhanced obstetrical and/or surgical skills provide cesarean delivery and family practice anesthetists manage anesthesia for labour pain and operative births at RSON-supported hospitals, with the involvement of a local specialist at one site.\nThe objectives of the study were to: (1) compare perinatal outcomes at hospitals participating in the RSON initiative with outcomes at referral hospitals and (2) examine temporal changes in the proportion of childbearing people who resided in RSON communities and gave birth locally.\nPoisson regression analysis was used to model the effect of hospital type (RSON vs. referral) on perinatal outcomes. We restricted the analysis to singleton births and controlled for differences in maternal characteristics, obstetric history, and pregnancy complications.\nChildbearing people who gave birth at RSON-supported hospitals (n\u00a0= 3498) had a 10% lower incidence of adverse maternal-newborn outcomes compared to those who gave birth at referral hospitals (n\u00a0= 14 772), after controlling for referral bias. We\u00a0found a small increase (3.2 %) in the proportion of local births over the study period.\nFindings provide evidence that childbearing people can safely give birth at smaller rural hospitals in British Columbia and that investments in rural hospitals contribute to service stability. Stabilizing local birth services in rural communities benefits the whole region because it reduces surgical overload in regional referral centres.",
    "authors": [
        {
            "affiliation": "Centre for Rural Health Research, Department of Family Practice, University of British Columbia, Vancouver, BC. Electronic address: kstoll@alumni.ubc.ca.",
            "firstname": "Kathrin",
            "initials": "K",
            "lastname": "Stoll"
        },
        {
            "affiliation": "Faculty of Medicine, University of British Columbia, Vancouver, BC.",
            "firstname": "Tessa A",
            "initials": "TA",
            "lastname": "Bendyshe-Walton"
        },
        {
            "affiliation": "Centre for Rural Health Research, Department of Family Practice, University of British Columbia, Vancouver, BC.",
            "firstname": "Gal",
            "initials": "G",
            "lastname": "Av-Gay"
        },
        {
            "affiliation": "Centre for Rural Health Research, Department of Family Practice, University of British Columbia, Vancouver, BC.",
            "firstname": "Anshu",
            "initials": "A",
            "lastname": "Parajulee"
        },
        {
            "affiliation": "Rural Coordination Center of British Columbia, Vancouver, BC.",
            "firstname": "Nancy",
            "initials": "N",
            "lastname": "Humber"
        },
        {
            "affiliation": "Rural Coordination Center of British Columbia, Vancouver, BC.",
            "firstname": "Kim",
            "initials": "K",
            "lastname": "Williams"
        },
        {
            "affiliation": "Rural Coordination Center of British Columbia, Vancouver, BC.",
            "firstname": "Tom",
            "initials": "T",
            "lastname": "Skinner"
        },
        {
            "affiliation": "Centre for Rural Health Research, Department of Family Practice, University of British Columbia, Vancouver, BC.",
            "firstname": "Jude",
            "initials": "J",
            "lastname": "Kornelsen"
        }
    ],
    "conclusions": "Findings provide evidence that childbearing people can safely give birth at smaller rural hospitals in British Columbia and that investments in rural hospitals contribute to service stability. Stabilizing local birth services in rural communities benefits the whole region because it reduces surgical overload in regional referral centres.",
    "copyrights": "Copyright \u00a9 2023 The Society of Obstetricians and Gynaecologists of Canada/La Soci\u00e9t\u00e9 des obst\u00e9triciens et gyn\u00e9cologues du Canada. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.jogc.2023.102280",
    "journal": "Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC",
    "keywords": [
        "British Columbia",
        "perinatal care",
        "pregnancy outcome",
        "rural health",
        "rural hospitals"
    ],
    "methods": null,
    "publication_date": "2023-11-11",
    "pubmed_id": "37949367",
    "results": "Childbearing people who gave birth at RSON-supported hospitals (n\u00a0= 3498) had a 10% lower incidence of adverse maternal-newborn outcomes compared to those who gave birth at referral hospitals (n\u00a0= 14 772), after controlling for referral bias. We\u00a0found a small increase (3.2 %) in the proportion of local births over the study period.",
    "title": "Perinatal Outcomes at Rural Hospitals That Participated in the Rural Surgical and Obstetrical Networks (RSON) of British Columbia (2016-2021).",
    "xml": "<Element 'PubmedArticle' at 0x78850368e840>"
}