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A significant cost differential obviously exists between inpatient and outpatient abortion services. The feasibility of providing outpatient vacuum aspiration procedures has been adequately demonstrated during the past few years, and as the fraction of women seeking early abortion increases the use of outpatient facilities should also increase. The effects of such a shift were also investigated.As the fraction of outpatient abortions was increased from a low of 10 per cent to a high of 90 per cent, the costs of providing services decreased by about one-third. Hospital patient-day requirements dropped dramatically. Such a shift requires, however, that women with preexisting conditions that may significantly increase their risk of mortality or morbidity be carefully screened and directed to the facility best able to treat them.The importance of the time point in pregnancy that the abortion is performed is evident. Early abortions have a multitude of health and economic benefits whereas late abortions present both an increased burden to the health care system and an increased threat to the woman's health.The national requirements for abortion services, at the level of services experienced in New York, or even somewhat higher, are not excessive. The space each facility, and the time each gynecologist, would have to allocate to these services is also not excessive, especially as an increasing fraction of abortions are performed during early pregnancy.Alternatives to abortion should also be widely available. The importance of contraceptive services, infertility treatment, and other aspects of comprehensive medical care for human reproduction should also be emphasized.

A pediatric transport system should be capable of rapidly delivering advanced pediatric skilled critical care to the patient's bedside at the referring hospital and of maintaining that level of care during transport to the receiving hospital. Physicians and others with special expertise in pediatric transport have developed specific recommendations for pediatric transport systems.1-9 The Committee on Hospital Care of the American Academy of pediatrics, in collaboration with expert consultants, offers the following guidelines for pediatric transport. These recommendations require periodic review as new equipment, techniques, and data evolve in this rapidly progressing field. Some of these recommendations may need modification to fit local circumstances. This statement modifies and enlarges upon a previously published chapter in the AAP manual, Hospital Care of Children and Youth.10 Neonatal transport systems have many of the same characteristics. OPTIMAL COMPONENTS OF A PEDIATRIC AIR-GROUND SYSTEM The most important components of a pediatric transport system are medical control by a qualified pediatric specialist and a medical transport team composed of individuals qualified to care for critically ill children in a transport setting. Although a pediatric transport system may share components with an adult transport system (eg, dispatch, vehicles, emergency medical technicians), it should have its own medical director, its own protocol, a transport team specifically trained in pediatric critical care, and equipment and supplies appropriate for the care of pediatric patients. An optimal pediatric transport system has available to it both air and ground ambulances combined into a flexible, coordinated system.

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