Private maternity hospital categorization in the province of Mendoza, Argentina: a reproducible health intervention?

Abstract

INTRODUCTION: Public institutions in Argentina comply with federal regulations and ministerial standards on perinatal health policies, but there is no information on compliance in the private health care system (PHCS). Due to worse results in very low birth weight (VLBW) infant survival and increased maternal mortality rates in PHCS, the province of Mendoza requested the collaboration of the National Ministry of Health for a categorizing evaluation. The objective of this health intervention was to categorize private maternity hospitals in the province and to compare the impact on VLBW infants. METHODS: All private maternity hospitals were categorized, and a prospective and cross-sectional evaluation of health intervention was performed. Compliance with ministerial standards was analyzed, and outcome of VLBW infants with  1500 grams was evaluated. RESULTS: Ten out of the twenty institutions were categorized. The remaining ones needed changes to obtain a category. The majority did not meet the standards regarding physical plant, equipment, quality, safety and human resources. Births of VLBW infants in high complexity PHCS increased from 74% to 87% (p<0.05), and mortality in this group decreased from 35% to 32% (p>0.05 NS). DISCUSSION: Mendoza underwent an unprecedented intervention in PHCS. This health intervention was effective, with favorable results especially in providing care for the most vulnerable newborns.