Hospital variation in admissions to neonatal intensive care units by diagnosis severity and category
- 1 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Perinatology
- Vol. 41 (3), 468-477
- https://doi.org/10.1038/s41372-020-00775-z
Abstract
Objective To examine interhospital variation in admissions to neonatal intensive care units (NICU) and reasons for the variation. Study design 2010-2012 linked birth certificate and hospital discharge data from 35 hospitals in California on live births at 35-42 weeks gestation and >= 1500 g birth weight were used. Hospital variation in NICU admission rates was assessed by coefficient of variation. Patient/hospital characteristics associated with NICU admissions were identified by multivariable regression. Results Among 276,489 newborns, 6.3% were admitted to NICU with 34.5% of them having mild diagnoses. There was high interhospital variation in overall risk-adjusted rate of NICU admission (coefficient of variation = 26.2) and NICU admission rates for mild diagnoses (coefficient of variation: 46.4-74.0), but lower variation for moderate/severe diagnoses (coefficient of variation: 8.8-14.1). Births at hospitals with more NICU beds had a higher likelihood of NICU admission. Conclusion Interhospital variation in NICU admissions is mostly driven by admissions for mild diagnoses, suggesting potential overuse.This publication has 17 references indexed in Scilit:
- Birth Hospitalization Costs and Days of Care for Mothers and Neonates in California, 2009-2011The Journal of Pediatrics, 2019
- Variation in Use by NICU Types in the United StatesPEDIATRICS, 2018
- Impact of NICU admission on Colorado-born late preterm infants: breastfeeding initiation, continuation and in-hospital breastfeeding practicesJournal of Perinatology, 2018
- Regional Variation in Neonatal Intensive Care Admissions and the Relationship to Bed SupplyThe Journal of Pediatrics, 2018
- Association Between Neonatal Intensive Care Unit Admission Rates and Illness AcuityJAMA Pediatrics, 2018
- Epidemiologic Trends in Neonatal Intensive Care, 2007-2012JAMA Pediatrics, 2015
- Screening parents of high-risk infants for emotional distress: rationale and recommendationsJournal of Perinatology, 2013
- Epidemiology and Diagnosis of Health Care–Associated Infections in the NICUPEDIATRICS, 2012
- Iatrogenic complications in the neonatal intensive care unitJournal of Perinatology, 2010
- Mothers’ experiences of having their newborn child in a neonatal intensive care unitScandinavian Journal of Caring Sciences, 2006