ABSTRACT
Historically, University teaching hospitals have been the primary providers of health
care to the indigent population. With the advent of managed health-care plans, the
university hospitals have seen a rapid decline in their obstetrical patient populations.
This decrease is reflected in the numbers of deliveries and gynecological surgeries.
From 1990 to 1995, these changes resulted in a significant decline in deliveries at
our hospital, the Lyndon B. Johnson General Hospital. To reverse this ominous trend,
we instituted a variety of changes resulting in a more patient-centered system and
found an improvement in the numbers of obstetrical patients. In the following report,
we describe these changes and the subsequent outcome.
Keywords
Health care management - resident education
