Accuracy and Completeness of Intermediate-Level Nursery Descriptions on Hospital Websites.
Accuracy and Completeness of Intermediate-Level Nursery Descriptions on Hospital Websites.
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DOI：
10.1001/jamanetworkopen.2022.15596
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发表时间：
2022-06-01
影响因子：
13.8
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中科院分区：
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医院网站如何完整准确地描述其二级特殊护理（即中级护理）托儿所？在这项对美国10个大州的医院托儿所（包括199万活产婴儿和268个二级单位）进行的横断面研究中，国家指定的中间（即，二级）单位分别在39%和25%的医院网站中描述不准确或不完整。各州的不完整性和不准确性率存在巨大且统计学显着差异。这些结果表明，医院的网站，往往是唯一的公开信息来源，描述了医院的新生儿病房，不提供可靠的信息，准父母，转诊医生和公众评估能力，照顾生病的新生儿。这项对美国10个大州的医院新生儿护理单位的横断面研究比较了州指定的中间护理单位与医院网站上公开描述的中间护理单位。在具有适当新生儿重症监护病房水平的医院出生与更好的新生儿结局相关。准父母、转诊医生和公众获得医院新生儿病房水平信息的主要来源是医院网站，但新生儿病房容量的准确性尚不清楚。确定医院网站是否准确报告了中级（即二级）病房的能力，这些病房旨在护理低至中度疾病水平的新生儿或在转移前稳定新生儿。这项横断面研究比较了10个大州的医院网页上的二级单位能力的描述与各自的国家级指定。分析的单位位于2019年活产人数最多的10个州（不包括没有二级法规的州），截至2021年5月，这些单位拥有活跃的网站。对医院网站进行了评估，以确定是否有任何提及该病房的内容，是否提供了该病房的描述，该病房是否被确定为三级或二级和三级，是否使用了“新生儿重症监护病房”或“新生儿重症监护病房”的术语，而没有说明现有护理或新生儿紧急程度的限制，或者该病房是否声称提供了最先进的护理水平。共有28个州没有对托儿所单位级别进行监管;在10个大的受监管的州中，39.2%的医院（95%CI，33.3%-45.3%）的二级单位的网络描述不完整，24.6%（95%CI，19.6%-30.2%）不准确。在不完整的描述中，2.6%（95% CI，1.1%-5.3%）的医院没有提到高级护理病房，22.0%（95% CI，17.2%-27.5%）的医院确定了二级病房，但没有提供进一步的描述。在不准确的描述中，25.4%（95% CI，20.3%-31.0%）的医院将该病房描述为“新生儿重症监护室”或“NICU”，没有任何资格，9.3%的医院将该病房描述为“新生儿重症监护室”或“NICU”，（95% CI，6.3%-13.5%）声称该单位提供了最先进的新生儿护理或对病情最严重的新生儿的护理; 3.0%的医院（95% CI，1.3%-6.0%）表示其单位为III级，1.5%（95% CI，0.4%-3.8%）为II级和III级。在各州之间，不完整和不准确的比率存在很大差异。不完整和不准确的医院网站描述的中间新生儿护理单位是常见的。这些缺陷可能会误导父母，临床医生和公众关于医院对患病新生儿的适当性，这引发了重要的伦理问题。
How completely and accurately do hospital websites describe their level II special care (ie, intermediate care) nurseries? In this cross-sectional study of hospital nurseries (including 1.99 million live births and 268 level II units) in 10 large US states that regulate nursery levels of care, state-designated intermediate (ie, level II) units were inaccurately or incompletely described in 39% and 25% of the hospital websites, respectively. There was substantial and statistically significant variation in rates of incompleteness and inaccuracy across states. These results suggest that hospital websites, often the only source of publicly available information describing a hospital’s neonatal unit, do not provide reliable information for prospective parents, referring physicians, and the public to assess the capacity to care for ill newborns. This cross-sectional study of hospital neonatal care units in 10 large US states compares state designations of intermediate-care units with how they are described publicly on hospital websites. Birth at hospitals with an appropriate level of neonatal intensive care units is associated with better neonatal outcomes. The primary sources for information about hospital neonatal unit levels for prospective parents, referring physicians, and the public are hospital websites, but the accuracy of neonatal unit capacity is unclear. To determine if hospital websites accurately report the capabilities of intermediate (ie, level II) units, which are intended for care of newborns with low to moderate illness levels or the stabilization of newborns prior to transfer. This cross-sectional study compared descriptions of level II unit capabilities on hospital web pages in 10 large states with their respective state-level designation. Analyzed units were located in the 10 states with the highest number of live births in 2019 (excluding states with no level II regulations) and had active websites as of May 2021. Hospital websites were assessed for whether there was any mention of the unit, the description of the unit was provided, the unit was identified as a level III or both levels II and III, the terms “neonatal intensive care unit” or “NICU” were used without indicating limits in care available or newborn acuity, or the unit was claimed to provide the most advanced level of care. A total 28 states had no regulation of nursery unit levels; in the 10 large, regulated states, web descriptions of level II units were incomplete for 39.2% of hospitals (95% CI, 33.3%-45.3%) and inaccurate for 24.6% (95% CI, 19.6%-30.2%). Within incomplete descriptions, 2.6% (95% CI, 1.1%-5.3%) of hospitals did not mention an advanced care unit and 22.0% (95% CI, 17.2%-27.5%) identified a level II unit without providing further description. Within inaccurate descriptions, 25.4% (95% CI, 20.3%-31.0%) of hospitals described the unit as a “neonatal intensive care unit” or “NICU” without any qualification and 9.3% (95% CI, 6.3%-13.5%) claimed that the unit provided the most advanced neonatal care or care to the sickest newborns; 3.0% of hospitals (95% CI, 1.3%-6.0%) stated that their unit was level III and 1.5% (95% CI, 0.4%-3.8%) as level II and III. Across states there was substantial variation in rates of incompleteness and inaccuracy. Incomplete and inaccurate hospital web descriptions of intermediate newborn care units are common. These deficits can mislead parents, clinicians, and the public about the appropriateness of a hospital for sick newborns, which raises important ethical questions.