The Effects of Patient Volume and Level of Care at the Hospital of Birth on Neonatal Mortality
A. Spitzer, C. Lipsky
Mar 1, 1997
Citations
35
Citations
Quality indicators
Journal
Clinical Pediatrics
Full text
Semantic Scholar
Key Takeaway Key Takeaway: Large Level III NICUs have significantly lower neonatal mortality rates compared to smaller Level III NICUs and Level II+ and Level II NICUs.
Abstract
process, 53,229 infants were classified as likely NICU admissions by this process. The primary outcome variable was death prior to 28 days of age. A logisitic regression model was used to control for differences in each patient's clinical and demographic data. The results of this study demonstrated that both patient volume and level of NICU care had a significant effect on mortality. Compared with hospitals without a NICU, infants born in hospitals with Level III NICUs with an average daily census of at least 15 patients per day had significantly lower risk-adjusted neonatal mortality (odds ratio, 0.62; 95% confidence interval, 0.47-0.82; P= .002). Risk-adjusted neonatal mortality for infants born in smaller Level III NICUs (<15 patients/day), and in Level II+ and Level II NICUs, regardless of size, was not significantly different from that in hospitals without a NICU and was significantly higher than that in hospitals with large Level III NICUs. Most importantly, costs for the birth of infants born at the hospitals with large Level III NICUs were