Philadelphia Obstetrics Crisis: Etiology, Implications, and Solutions For Maintaining Quality Obstetric Care and The Viability of Academic Medicine

The Philadelphia area has been the site of an unprecedented number of maternity unit closures over the past 15 years. Staring with the closure of the maternity floor at Medical College of Pennsylvania Hospital in 1997 and culminating this summer with the closure of Northeastern Hospital planned for June 2009, a total of 16 providers of obstetrical care will have been eliminated. This has lead to nearly a 35 percent decrease in the number of staffed maternity beds in the city. The reasons postulated have been identified as a combination of high malpractice and low reimbursement. Thus far all of the 15 closures have been community hospitals in the area, many of which have provided obstetrical care to the city of Philadelphia for the last 50-100 years. In contrast, the six remaining providers of maternity care in the city of Philadelphia are all academic medical centers. The strengths, weaknesses and missions of community versus academic medical facilities play a significant role in this outcome. The questions to be examined in this paper are what are the reasons for these closures. If it is due to malpractice and reimbursement issues, why have academic medical centers thus far persevered in the face of this environment? What are the implications for both maternity care and medical training at institutions in the city if this situation is not resolved? Lastly is the current situation sustainable and what are some possible solutions to the crisis for the area.M.P.H., Public Health -- Drexel University, 200