Access to Birthing-Friendly Facilities for Maternal Care

Preventable maternal mortality in the U.S. has grown considerably and spurred the federal government into action, most noticeably with the development of the White House Blueprint for Addressing the Maternal Health Crisis (PDF). 对有色人种和资源不足或边缘化人口产生不利影响的孕产妇死亡率和发病率差距日益扩大，加剧了这一危机.

CMS Birthing-Friendly Designation

作为改善产妇健康的持续努力的一部分，医疗保险中心 & 医疗补助服务(CMS)已经开始分配一个“分娩友好”的称号，以确定参与州或国家围产期质量改善合作的设施，并实施患者安全实践或捆绑作为这些倡议的一部分. By designating hospitals as birthing-friendly and, through this, signaling the consistent use of evidence-based practices in maternal care, CMS希望增加并进一步确保获得高质量的围产期服务，帮助准父母找到他们想要和应得的高质量护理.

Access to High-Quality Maternal Care Varies Widely

趣赢平台最近对CMS分娩友好指定数据的分析发现，CMS目前指定为分娩友好的州内设施的比例差异很大. Sixteen states currently have more than 80% of their birthing facilities designated as birthing-friendly while 6 have fewer than 40%. 指定分娩友好设施达到80%以上的州主要位于该国东部，加利福尼亚州和新墨西哥州除外. 被指定为分娩友好设施的州不到40%，这些州位于中西部和西北部，农村县高度集中. These counties are more likely to be “maternity care deserts,” characterized by a scarcity of maternity care resources and, consequently, uneven access to high-quality maternity care. 大多数州都可以夸耀自己至少有一半的设施被指定为分娩友好型设施. See Figure 1.

Figure 1 Image Description

Transforming Care with Best Practices

Through the recently announced Transforming Maternal Health (TMaH) Model, CMS希望鼓励更多地使用孕产妇保健质量改进/患者安全捆绑包和其他已建立的最佳做法. 患者安全捆绑包已得到完善，是世卫组织支持的一种方法 Alliance for Innovation on Maternal Health (AIM), in which nearly all states participate. 分娩友好指定医院的比例与各州最初参与AIM的比例之间的关联表明，CMS的产学研目标是向前迈出的一步. The earlier that states began in AIM, 他们就越有可能让至少60%的医院被指定为分娩友好型医院. Specifically, among states that initiated AIM participation in 2019 or earlier, 89%的州至少有60%的设施被指定为分娩友好型，而在2020年或之后开始实施AIM的州中，只有一半的州可以做出同样的声明. See Figure 2.

Figure 2 Image Description

全国各地指定为分娩友好的设施所占比例的差异，突显了围产期护理方面存在差异的严峻现实. 在农村人口高度集中的几个州，医院被指定为分娩友好型医院的可能性要小得多, leaving fewer high-quality options for residents there. 预期的TMaH模式可以支持寻求实现这一称号的医院，以促进改善产妇护理. In advance of TMaH, CMS可能会考虑优先向缺乏既定计划或资源来实施患者安全捆绑包和需要最多支持的州提供服务, 并找出从生育友好设施比例高的州吸取的经验教训.

多米尼克·埃斯波西托博士提交，行为健康和健康政策副总裁. Hollie Harsanyi, MPH, a Senior Research Associate for Social Policy and Economics Research, developed the maps presented here.