DECLINES IN PATIENT VOLUME - AN OBSTETRICS AND GYNECOLOGY TEACHING PROGRAMS RESPONSE

Historically, University teaching hospitals have been the primary prov iders of health care to the indigent population. With the advent of ma naged health-care plans, the university hospitals have seen a rapid de cline in their obstetrical patient populations. This decrease is refle cted in the numbers of deliveries and gynecological surgeries. From 19 90 to 1995, these changes resulted in a significant decline in deliver ies at our hospital, the Lyndon B. Johnson General Hospital. To revers e 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 c hanges and the subsequent outcome.