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Study shows decline in maternity care workforce due to malpractice insurance

A study led by Ariel Smits, MD, MPH, Department of Family Medicine, shows that Oregon continues to lose maternity care providers. Information drawn from the study abstract describes how the team surveyed all obstetrical care providers in Oregon in 2002 and 2006. Survey data, supplemented with state administrative data, were analyzed for changes in provision of maternity care and reasons for stopping maternity care.  

Results show that only 36.6 percent of responding clinicians qualified to deliver babies were actually providing maternity care in Oregon in 2006, significantly lower than the proportion (47.8 percent) found in 2002. Cost of malpractice premiums remains the most frequently cited reason for stopping maternity care, followed by lifestyle issues.                                                          

A goal of the study was to examine how Oregon's rural liability subsidy is affecting rural maternity care providers' ability to provide maternity care services. Most providers receiving the subsidy reported that it was very important to their continued provision of maternity care. However, statistical analysis found that the subsidy alone was not effective at keeping maternity care providers delivering babies. Call support, practice coverage and increased reimbursement should also be considered. 

The study was funded by a grant from the American Academy of Family Physicians, the Oregon Medical Association, and OHSU Family Medicine Research Division. For additional information, contact Dr. Smits or John Saultz, MD, Chair, Department of Family Medicine. The full paper is in the August issue of Health Services Research.      

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