Risk-Appropriate Care for High-risk Births: An Evaluation of Process Outcomes of Perinatal Regionalization Systems
Bibliographic record
Abstract
Perinatal regionalization is a coordinated system that distributes perinatal services across hospitals within a region according to their level-of-care designation. While guided by a structured framework, its implementation varies widely, raising questions about the effectiveness of current systems in improving maternal and neonatal outcomes in an ever-evolving healthcare field. This thesis aimed to evaluate perinatal regionalization systems and their process outcomes through two studies. The first is a systematic review of global perinatal regionalization systems. Findings revealed that most high-risk births occurred in risk-appropriate facilities, with such deliveries associated with favourable outcomes, including reduced perinatal/neonatal/infant mortality. The second, an exploratory study using Ontario’s 2011–2019 Discharge Abstract Database to examine the distribution of birth hospitals by gestational age, demonstrated that most high-risk births, identified as preterm, occurred in hospitals within the top tertile of delivery volume. Together, these findings provide a comprehensive evaluation of how these systems function within today’s healthcare landscape.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".