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http://www.boston.com/dailyglobe2/021/science/Survival_rates_of_babies_not_tied_to_quality_of_care+.shtml

Survival rates of babies not tied to quality of care

By Reuters, 1/21/2003

OSTON - When it comes to having doctors who specialize in the medical problems of premature infants, a new study suggests that more is not necessarily better, according to the New England Journal of Medicine.

A research team from Dartmouth Medical School in Hanover, N.H., found that premature babies were just as likely to survive in regions of the United States where the number of specialists and the number of special neonatal care units was below average, compared to regions where the number was high.

Only in areas where the specialist population was extremely low - about 2.7 neonatologists per 10,000 births - did they see a decrease in survival.

The results suggest that once a region has reached a critical mass of intensive-care units for newborns, and once the number of doctors available to care for the babies has reached a certain point, adding more units and more doctors will not improve the chances of survival.

The findings ''raise disturbing issues regarding the nation's unquestioning acceptance that more is always better with respect to the supply of specialist physicians and hospital technology,'' Dr. Kevin Grumbach of the University of California at San Francisco stated in an editorial in the New England Journal of Medicine.

A team led by Grumbach and Dr. David C. Goodman warn that it's possible that babies can be harmed if they are subjected to too much specialized care.

''Infants with less serious illness might be more likely to be admitted to a neonatal intensive-care unit and might be subjected to more intensive diagnostic and therapeutic measures,'' and the risks they entail, researchers said.

This story ran on page C5 of the Boston Globe on 1/21/2003.
© Copyright 2003 Globe Newspaper Company.

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