Birth and Perinatal Assistance Network on the Territory: Model and Simulation of Service Dynamical Behaviour.

We consider a geographical region where population is distributed in health districts. In the same region there exists a three-tiered neonatal care network, which includes birth centres for supplying basic assistance for delivery, neonatal care and neonatal intensive care, with a design such that all higher-level centres also provide the lower levels of assistance. Each mother-to-be is admitted to a facility serving the level corresponding to the expected newborn conditions, based on pregnancy course; newborn transfers from a lower to a higher-level facility are feasible if the newborn conditions worsen. A simulation model describing mothers and newborns movements from districts to birth centres and among birth centres has been built up, with the aim of revealing lacks and inadequacies in supplying the required assistance in birth centres close enough to patients’ homes. The model has been implemented in MicroSaint student on a personal computer and applied to Veneto region in North-East Italy but its use may be extended to other similar situations.