Quality, outcome, and cost of care provided to very low birth weight infants in California

To examine association of costs with quality of care and patient outcome across hospitals in California. Retrospective 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 scor...

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Bibliographic Details
Published in:Journal of perinatology 2024-02, Vol.44 (2), p.224-230
Main Authors: Lapcharoensap, Wannasiri, Bennett, Mihoko, Xu, Xiao, Lee, Henry C, Profit, Jochen, Dukhovny, Dmitry
Format: Article
Language:English
Subjects:
Birth Weight
California
Clinical outcomes
Correlation coefficient
Correlation coefficients
Generalized linear models
Health care expenditures
Hospitals
Humans
Infant
Infant, Newborn
Infant, Very Low Birth Weight
Infants
Intensive Care Units, Neonatal
Low birth weight
Morbidity
Neonatal care
Premature babies
Quality of care
Retrospective Studies
Risk
Risk Factors
Statistical models
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Summary:To examine association of costs with quality of care and patient outcome across hospitals in California. Retrospective 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. In 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). With the metrics used, we found no correlation between cost, quality, and outcomes in the care of VLBW infants.
ISSN:0743-8346
1476-5543
1476-5543
DOI:10.1038/s41372-023-01792-4