[Risk-adjusted assessment of neonatology wards by the new quality indicator "transfer rate of mature newborns"]

Abstract

Objective: 1. The transfer rate of mature newborns will be presented as a new quality indicator. 2. Another objective of this study was to adjust the transfer rate of mature newborns of different hospitals according to their "risk" profile of patients by multivariate analysis.

Method: The perinatal database of 118,416 newborns of the Saxonian quality surveillance from 2001 to 2004 was analysed. Based on 17 clinical and 3 structural factors, a logistic regression model was used to develop a specific "risk" predictor for the quality indicator "transfer rate".

Results: For care level III (basic care) a "risk" predictor for the transfer rate was developed, which consists of 15 factors. The AUC(ROC)-value of this quality indicator was 78.6%, which is sufficient. The hospital ranking based on the adjusted risk assessment was different from the hospital ranking prior to this adjustment. The average correction of ranking position was 10.4 for 43 clinics.

Conclusion: 1. The new quality indicator "transfer rate of mature newborns" can be recommended. 2. The application of the risk adjustment method proposed here allows for a more objective comparison of the quality indicator "transfer rate" among different hospitals.