Indiana University Medical Center is the major referral center for the entire state of Indiana, with a population of 5.5 million and 80,000 births annually. Located in the center of the state, the Medical Center has the largest neonatal and perinatal services in Indiana, all situated within three facilities in close physical proximity to one another and connected by underground tunnels. The James Whitcomb Riley Hospital for Children is a state-of-the-art 261-bed tertiary care referral hospital, owned and operated by Indiana University, which contains a 25,000 square foot, 42-bed maximum tertiary care newborn intensive care unit. There are 720 admissions to this unit annually, 80% from outside of the Medical Center and transferred to the unit by a transport team. An average daily census of 45 infants includes 30 infants on ventilator support. University Hospital provides a high risk obstetric referral service for 1,200 deliveries annually and has an 18-bed intensive care newborn service for level II care which receives 600 admissions annually. Wishard Memorial Hospital is a county health facility with an active delivery service of 3,500 patients annually and a 16-bed intensive care newborn facility with 620 admissions per year. There are 1,700 admissions annually to the newborn intensive care facilities at the Medical Center, of which 550 represent neonatal transfers and 1,150 are inborn patients. This service is supported by nine full-time board certified neonatologists, six neonatology fellows, three full-time developmental pediatricians with two developmental fellows, a large pediatric residency program (51 pediatric house officers and 18 combined pediatric/medicine house officers) and support staff. A full complement of pediatric medical and surgical subspecialists is available. A large obstetric faculty with four board certified perinatologists and two perinatology fellows is present. An extensive perinatal/neonatal data system has been developed for computerized collection and analysis of clinical information. An established follow-up clinic has been in place since 1976, under the leadership of Dr. Marilyn Bull, a developmental pediatrician and board certified geneticist. The Section of Neonatal-Perinatal Medicine has a long standing commitment to basic and clinical research, evidenced by current NIH grants supporting basic and clinical research programs, past participation in several multicenter randomized """"""""prospective trials and an extensive i publication record. The section has two experienced full-time research nurse coordinators, eight fulltime research technicians, two Ph.D. research associates, well-equipped clinical and basic research laboratories, a data coordinator, six inpatient and five outpatient neonatal nurse practitioners, good collaborative working relationships with many other departments in the performance of research, and strong departmental and institutional support. The section has experience with and is supportive of a capitation system for funding of specific protocols and is anxious to participate in multicenter trials.
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