Table of Contents
ISRN Obstetrics and Gynecology
Volume 2013 (2013), Article ID 709616, 5 pages
http://dx.doi.org/10.1155/2013/709616
Research Article

The Impact of Centralization of Obstetric Care Resources in Japan on the Perinatal Mortality Rate

Department of Public Health, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki City, Miyazaki 889-1692, Japan

Received 31 May 2013; Accepted 20 August 2013

Academic Editors: L. G. Bahamondes, L. Gebrim, and A. Martin-Hidalgo

Copyright © 2013 Akira Sudo and Yoshiki Kuroda. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. We investigated the effects of the centralization of obstetricians and obstetric care facilities on the perinatal mortality rate in Japan. Methods. We used the Gini coefficient as an index to represent the centralization of obstetricians and obstetric care facilities. The Gini coefficients were calculated for the number of obstetricians and obstetric care facilities of 47 prefectures using secondary medical care zones as units. To measure the effects of the centralization of obstetricians and obstetric care facilities on the outcomes (perinatal mortality rates), we performed multiple regression analysis using the perinatal mortality rate as the dependent variable. Results. Obstetric care facilities were more evenly distributed than obstetricians. The perinatal mortality rate was found to be significantly negatively correlated with the number of obstetricians per capita and the Gini coefficient of obstetric care facilities. The latter had a slightly stronger effect on the perinatal mortality rate. Conclusion. The centralization of obstetric care facilities can improve the perinatal mortality rate, even when increasing the number of obstetricians is difficult.