Hospital variation in extremely preterm birth.
Hospital variation in extremely preterm birth.
复制标题
极早产的医院差异。
DOI：
10.1038/s41372-022-01505-3
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Lee,HenryC
中科院分区：
文献类型：
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作者：
Goldstein,GregoryP;Kan,Peiyi;Phibbs,CiaranS;Main,Elliott;Shaw,GaryM;Lee,HenryC
鉴于极早产(EPTB)的区域化与改善婴儿结局有关，我们评估了极早产在医院新生儿护理水平的医院间差异，并确定了由产妇和医院因素差异解释的差异的比例。研究设计我们使用出院、出生和死亡证明数据评估了1997至2011年间加州的7,046,253名新生儿。我们使用多变量回归估计母体和医院因素与EPTB之间的关联，计算医院特定的EPTB频率，并估计医院间的方差和中位优势比，按医院护理级别分层。结果EPTB的医院频率范围为0%到2.5%。尽管按医院护理水平分层并考虑了混杂因素，但医院间的EPTB频率差异很大。结论我们的结果显示，1级和2级新生儿护理医院的EPTB存在差异，这是未来研究和质量改进的目标领域。
ObjectiveGiven that regionalization of extremely preterm births (EPTBs) is associated with improved infant outcomes, we assessed between-hospital variation in EPTB stratified by hospital level of neonatal care, and determined the proportion of variance explained by differences in maternal and hospital factors.Study designWe assessed 7,046,253 births in California from 1997 to 2011, using hospital discharge, birth, and death certificate data. We estimated the association between maternal and hospital factors and EPTB using multivariable regression, calculated hospital-specific EPTB frequencies, and estimated between-hospital variances and median odds ratios, stratified by hospital level of care.ResultHospital frequencies of EPTB ranged from 0% to 2.5%. Between-hospital EPTB frequencies varied substantially, despite stratifying by hospital level of care and accounting for confounding factors.ConclusionOur results demonstrate differences in EPTBs among hospitals with level 1 and 2 neonatal care, an area to target for future research and quality improvement.