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PubMed1990

Birth order in small multihospital systems.

The strategic behaviors of small multihospital systems have received little attention in the literature despite the fact that small systems are the predominant scale among multihospital systems. This study examines one important aspect of small-system strategic behaviors: the birth-order or evolutionary patterns of hospital acquisition. The evolutionary patterns of acquisition are compared across three strategic model types studied elsewhere: local market, investment, and historical. Using data obtained from a variety of sources, local market model systems are found, in the sequence of acquisition, to be significantly different from the other two model types in terms of relative distances of acquisitions from the initiating or parent hospital, the sizes of acquisition hospitals, the complexity of those hospitals, and the likelihood that the acquisitions are located in rural areas. Differences between parents and acquisitions are also significant, as hypothesized, for the market model system types, although they are not generally significant for the other two model types. The findings suggest that the market model represents an important strategic form that may have important implications for the restructuring of hospital markets.

Health Facilities↗
PubMed1988

Birth order in delivery of twins.

A comparison between the first-born twin A and the second-born twin B was made in 103 pairs of twins delivered vaginally at the Department of Obstetrics and Gynecology, Wakayama Medical College, and at Kosaka Women's Hospital. The twins were compared for birth weight, 1- and 5-min Apgar scores, and umbilical blood gas and pH. Although the mean values showed no significant difference in birth weight between twin A and twin B, the 1- and 5-min Apgar scores were higher for twin A, and the incidence of low 1- and 5-min Apgar scores was greater for twin B. The B twins with a birth weight less than 2,500 g or delivered in the nonvertex presentation were especially at disadvantage. Blood gas analysis revealed a significant difference favoring twin A in umbilical PO2 and PCO2. The results of the present study suggest that there are differences at birth favoring the A twins despite similar perinatal mortality for both and that the B twins are at disadvantage.

Apgar Score↗