Obstetrical Services and Population-Based Outcomes in Rural British Columbia

June 2000 - May 2004

Research Team

Principal Investigators: Stefan Grzybowski, Michael Klein, Robert Liston, Robert Reid, Elizabeth Torr, Andrew Kotaska

Support Team:  Christa Peters

Funding Agency

British Columbia's Children's Hospital Foundation (Telethon Fund)

Project Summary

The purpose of this study was to examine the safety of the different levels of maternity care service provided in rural communities in British Columbia (BC) by comparing the perinatal outcomes of population catchments using provincial data for 1994-1999. A number of methodological challenges were identified and explored in this pilot work, such as a lack of catchment population mapping for rural hospital services in British Columbia.

Through this research, hospital catchments were approximated for each of the 62 rural maternity services in BC. Twenty rural hospitals had no local C-Section availability (Level 1A) and 69% of births (N=7536) occurred away from the local hospital in this strata. In comparison to similar and slightly larger facilities with GP surgeons on staff (able to provide local C/S) there were significantly more Special Care Nursery admissions to 1A hospital catchments (p = .003 after adjustment for SES and aboriginal status). There was no differences in perinatal mortality for any of the service levels.

Project Update

A continuation of this pilot work is currently underway, funded by the Canadian Institutes of Health Research (ICE grant).  A data request has been submitted to the British Columbia Reproductive Care Program for 2000-2004.