Changes in hospital quality at hospitals serving black and hispanic newborns below 30 weeks' gestation

Abstract

Objective: Examine whether the quality of Black and Hispanic serving (BHS) compared with not BHS (NBHS) NICUs has changed differentially over time.

Study design: Infants 24-29 weeks' gestation born at U.S. Vermont Oxford Network centers (2006-2018) were studied. We calculated adjusted hospital quality scores as the predicted probabilities of composite in-hospital mortality and morbidities from a logistic model. We regressed hospital quality scores on birth year to estimate the linear temporal slope by BHS-serving status for hospitals within each Census division.

Results: Hospital quality improved similarly over time for BHS and NBHS hospitals across all divisions except West South Central where a mean change in the composite score was -18.8 (95% CI: -24.1, -13.5) for NBHS and -9.3 (95% CI: -14.1, -4.6) for BHS hospitals (p-value = 0.009).

Conclusion: Hospital quality improved similarly for BHS and NBHS hospitals across most divisions. Variation within and between divisions should be a focus for quality improvement.