Quality, outcome, and cost of care provided to very low birth weight infants in California.
Quality, outcome, and cost of care provided to very low birth weight infants in California.
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加利福尼亚州为极低出生体重婴儿提供的护理质量、结果和成本。
DOI：
10.1038/s41372-023-01792-4
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Dukhovny,Dmitry
中科院分区：
文献类型：
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作者：
Lapcharoensap,Wannasiri;Bennett,Mihoko;Xu,Xiao;Lee,HenryC;Profit,Jochen;Dukhovny,Dmitry
目的研究成本与加州各医院的护理质量和患者结局的相关性。方法回顾性研究2014-2018年极低出生体重（VLBW）出生，将出生证明、出院记录和临床数据联系起来。使用Baby-MONITOR评分来衡量质量。临床结果用无重大发病率生存率（SWMM）来衡量。分层广义线性模型，调整临床因素，用于估计风险调整措施的成本，质量和结果为每家医院。这些措施之间的关联进行了评估，使用Pearson相关系数。ResultsIn总数，15,415名婴儿从104 NICU。风险调整后的婴儿监测评分、SWMM率和成本差异很大。风险调整成本与Baby-MONITOR评分之间无相关性（r= 0，p= 0.998）。风险调整成本和SWMM率之间的相关性呈反比且不显著（r=-0.07，p = 0.48）。
ObjectiveTo examine association of costs with quality of care and patient outcome across hospitals in California.MethodsRetrospective study of very low birth weight (VLBW) births from 2014–2018 linking birth certificate, hospital discharge records and clinical data. Quality was measured using the Baby-MONITOR score. Clinical outcome was measured using survival without major morbidity (SWMM). Hierarchical generalized linear models, adjusting for clinical factors, were used to estimate risk-adjusted measures of costs, quality, and outcome for each hospital. Association between these measures was evaluated using Pearson correlation coefficient.ResultsIn total, 15,415 infants from 104 NICUs were included. Risk-adjusted Baby-MONITOR score, SWMM rate, and costs varied substantially. There was no correlation between risk-adjusted cost and Baby-MONITOR score (r= 0,p= 0.998). Correlation between risk-adjusted cost and SWMM rate was inverse and not significant (r= −0.07,p= 0.48).ConclusionsWith the metrics used, we found no correlation between cost, quality, and outcomes in the care of VLBW infants.