The Effect of Neonatal Intensive Care Level and Hospital Volume on Mortality of Very Low Birth Weight Infants

• DOI: 10.1097/mlr.0b013e3181dbe887
• Publication Date: 2010-06-12T09:30:21Z
• Authors: Judith H. Chung; Ciaran S. Phibbs; W. John Boscardin; Gerald F. Kominski; Alexander N. Ortega; Jack Needleman
• Keywords: Adult; Chi-Square Distribution; Infant, Newborn; Hospitals, Pediatric; California; 3. Good health; 03 medical and health sciences; Logistic Models; 0302 clinical medicine; Hospital Bed Capacity; Intensive Care Units, Neonatal; Infant Mortality; Odds Ratio; Humans; Infant, Very Low Birth Weight; Female; Maternal Age

To determine the adjusted effect of hospital level care and volume on mortality very low birth weight (VLBW) infants in state California, where deregionalization perinatal has occurred.Secondary data analysis California maternal-infant discharge from 1997 to 2002 was performed. Logistic regression used evaluate odds among VLBW by neonatal intensive deliveries, context differences antenatal delivery factors site delivery.Both maternal fetal risk profiles characteristics vary delivery. After adjustment, lower-level, lower-volume units were associated with a higher mortality. The highest occurred level-1 < or =10 deliveries per year (odds ratio, 1.69; 95% confidence interval, 1.43-1.99). In isolation, volume, rather than care, had greater effect.Although services may increase access for high-risk mothers newborns, its impact outweigh potential benefit.