Examining the effect of hospital-level factors on mortality of very low birth weight infants using multilevel modeling
Examining the effect of hospital-level factors on mortality of very low birth weight infants using multilevel modeling
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DOI：
10.1038/jp.2011.29
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发表时间：
2011-12-01
影响因子：
2.9
通讯作者：
Needleman, J.
中科院分区：
文献类型：
--
作者：
Chung, J. H.;Phibbs, C. S.;Needleman, J.
目的：本研究的目的是探讨医院水平的因素对极低出生体重儿死亡率的影响，采用多水平modeling.Study设计：这是一个二级数据分析加州母婴出院数据从1997年至2002年。研究人群仅限于在提供新生儿重症监护服务（2级及以上）的医院分娩的单胎、非异常、极低出生体重儿。分层广义线性模型，也被称为多层次模型，用于调整个人水平confersider.Result：在一个多层次模型中，增加极低出生体重分娩的医院数量与极低出生体重死亡率的几率较低。一个特定的医院的产科和新生儿服务的特点（住院医师和奖学金培训计划的存在和围产期和新生儿服务的可用性）没有独立的effect.Conclusion：使用多层次建模，医院的极低出生体重分娩量似乎是极低出生体重儿死亡率降低的主要驱动因素。Journal of Perinatology（2011）31，770-775; doi：10.1038/jp.2011.29; 2011年4月14日在线发表
Objective: The objective of this study was to examine the effect of hospital-level factors on mortality of very low birth weight infants using multilevel modeling.Study Design: This is a secondary data analysis of California maternal-infant hospital discharge data from 1997 to 2002. The study population was limited to singleton, non-anomalous, very low birth weight infants, who delivered in hospitals providing neonatal intensive care services (level-2 and higher). Hierarchical generalized linear modeling, also known as multilevel modeling, was used to adjust for individual-level confounders.Result: In a multilevel model, increasing hospital volume of very low birth weight deliveries was associated with lower odds of very low birth weight mortality. Characteristics of a particular hospital's obstetrical and neonatal services (the presence of residency and fellowship training programs and the availability of perinatal and neonatal services) had no independent effect.Conclusion: Using multilevel modeling, hospital volume of very low birth weight deliveries appears to be the primary driver of reduced mortality among very low birth weight infants. Journal of Perinatology (2011) 31, 770-775; doi: 10.1038/jp.2011.29; published online 14 April 2011