Measuring severe neonatal morbidity using hospital discharge data in France

• DOI: 10.1111/ppe.12816
• Publication Date: 2021-11-19T15:13:26Z
• Authors: Elodie Lebreton; Claudie Menguy; Jeanne Fresson; Natalia N. Egorova; Catherine Crenn H...; Jennifer Zeitlin
• Keywords: Funnel plot; Neonatology; Hospital discharge

Measuring infant health at birth is key for surveillance and research in obstetrics neonatology, but there no international consensus on morbidity indicators. The Neonatal Adverse Outcome Indicator (NAOI) a composite indicator, developed Australia, which measures the burden of severe neonatal using hospital discharge data.To evaluate applicability NAOI France research.We constituted cohort live births ≥24 weeks' gestational age Metropolitan from 2014 to 2015 discharge, insurance claims cause death data. Outlier hospitals were identified funnel plots standardised ratios (SMR), their coding patterns assessed. We compared its component codes with published Australian English data estimated unadjusted adjusted risk known factors morbidity.We included 1,459,123 (511 hospitals). Twenty-eight had SMR above plot control limits. Newborns morbidities these lower mortality shorter stays than other hospitals. Amongst within-limit hospitals, prevalence was 4.8%, comparable Australia (4.6%) England (5.4%). Most individual components similar prevalence, exception respiratory support, intravenous fluid procedures infection. lowest 39 weeks (2.2%) higher risks maternal ≥40 (relative [RR] 1.47, 95% confidence interval [CI] 1.42, 1.51), state medical (RR 1.60, CI 1.52, 1.68), male sex 1.21, 1.19, 1.23) birthweight <3rd percentile 4.60, 4.51, 4.69).The provides valuable information population factors. Whilst high-income countries levels, ensuring valid comparisons between will require further work harmonize procedures, especially infection morbidity.