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March 30, 1979, Vol 241, No. 13 >
ARTICLE | March 30, 1979

Cost of Obstetric Services-Reply

Herman A. Hein, MD; Norma N. Ferguson, RN
JAMA. 1979;241(13):1326. doi:10.1001/jama.1979.03290390014012.
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ABSTRACT

We hope our article is not being used as a defense for freestanding obstetric services of any size. We feel strongly that all obstetric services should be linked to a referral center, and this linkage should include regular patient care review and appropriate remedial education.

A careful review of the article will show that we did not attempt to show that small hospitals are more cost-effective than large hospitals. Such a study would be practically impossible, since methods of cost accounting vary widely among hospital administrators. Rather, we hoped to draw attention to the fact that health planners are unpersuasive in their argument that consolidation of obstetric services will improve the quality of care and the efficiency of the service (240:2070, 1978; 240:2051, 1978). Our data are really straightforward. They show what the patient pays for basic services in the different hospital categories. We cannot make any attempt

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