This case study analyzes a decade of birth data in Arkansas to evaluate whether newborns receive care at the appropriate level of neonatal facility. It finds that triage decisions are driven more by geography than clinical need — only 20% of births occurred at risk-appropriate facilities, with over-triage dominating in well-resourced areas and under-triage concentrated in rural areas far from appropriate care. Medicaid-insured infants faced disproportionately higher rates of under-triage, and hospital closures worsened access further. The authors call for reconfiguring the regionalized perinatal system to better match neonatal care resources with actual clinical need.
Case Study Link: Inequitable Access to Risk-Appropriate Neonatal Care: Evidence from a Regionalized Perinatal System in Arkansas
Case Study Contact: Sandra Eksioglu, sandra@uark.edu