Weekend birth and higher neonatal mortality: A problem of patient acuity or quality of care?
Weekend birth and higher neonatal mortality: A problem of patient acuity or quality of care?
复制标题
DOI：
10.1177/0884217503258306
复制
发表时间：
2003-11-01
影响因子：
1.8
通讯作者：
Restrepo, E
中科院分区：
文献类型：
--
作者：
Hamilton, P;Restrepo, E
目的：为了解决出生的未成年母亲在工作日和周末之间的新生儿死亡率的差异。设计：一个回顾性的描述性设计。新生儿死亡率与母亲的危险因素，低出生体重，胎龄，出生的一周中的一天，和种族/race.Patients/参与者：人口包括所有记录的出生在得克萨斯州1999年和2000年（N = 111,749）的少女母亲（< 20岁）。这些出生被链接到同一时间段（n = 397）内的新生儿死亡的一个子集的死亡证明书：主要结果Measures：利益的结果是任何死亡归因于起源于围产期的条件，并记录为这样的婴儿死亡certificate.Results：新生儿死亡率是在出生的周末比那些在一周内。母亲和婴儿的母亲风险和患者敏锐度水平并不总是在周末更高。然而，当风险因素存在时，周末出生的西班牙裔比其他种族或racial groups.Conclusions：患者急性期的差异并不能令人满意地解释周末新生儿死亡率较高。因此，护理质量指标，如医院工作人员减少和周末服务减少，可能是不必要的新生儿死亡的关键来源。
Objective: To address the differences in neonatal mortality among births to teenage mothers on weekdays and weekends.Design: A retrospective descriptive design. Rates of neonatal mortality linked to maternal risk factors, low birth weight, gestational age, day of the week of the birth, and ethnicity/race were examined.Patients/Participants: The population consisted of all recorded births to teenage mothers (< 20 years of age) in Texas in 1999 and 2000 (N = 111,749). These births were linked to death certificates for a subset of neonatal deaths within the same time period (n = 397).Main Outcome Measures: The outcome of interest was any death attributed to conditions originating in the perinatal period and recorded as such on the infant death certificate.Results: Neonatal mortality was higher among the births on weekends than those during the week. Maternal risks and patient acuity levels of mothers and babies were not consistently higher on weekends. However, when risk factors were present, weekend births were more dangerous for Hispanics than for other ethnic or racial groups.Conclusions: Differences in patient acuity did not satisfactorily explain higher neonatal mortality rates on weekends. Thus, quality of care indicators such as lower hospital staffing and reduced availability of services on weekends may be critical sources of unnecessary neonatal deaths.