Regionalization of level-3 neonatal care is advocated by many, as several studies have showed that outcome is better in large/regional NICUs.

However, the question of regionalization might be more complicated when it comes to implementation.

The 99nicu Poll in april is about policies of regionalization, and how they seem to work in practise.

Take the opportunity to post your comments too!

Do you have any links for some of the articles, Stefan?

Here's a few studies, I take the opportunity to cite myself in the first one

Preterm Delivery, Level of Care, and Infant Death in Sweden: A Population-Based Study

The Effect of Birth in Secondary- or Tertiary-Level Hospitals in Finland on Mortality in Very Preterm Infants: A Birth-Register Study

Perinatal Regionalization for Very Low-Birth-Weight and Very Preterm Infants

Level and Volume of Neonatal Intensive Care and Mortality in Very-Low-Birth-Weight Infants

Examining the effect of hospital-level factors on mortality of very low birth weight infants using multilevel modeling

There was a pretty good study published by the march of dimes in 2001 by Dr Ellen R Shaffer, her email was ershaffer@earthlink.net I do not know if it is still correct but you can still see her paper on line.

Thanks for the excellent links!

I found the study you mentioned, plyon0962

http://www.centerforpolicyanalysis.org/wp-content/uploads/Final-NICU-Report.pdf

And, here's a study from the UK about re-organisation, published in BMJ just a few days ago.

Survival increased during recent years.

http://www.bmj.com/content/344/bmj.e2105

Ah yes! I had the chance to meet the author in London - he said the paper was coming up. Nice bloke!