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

Wannasiri Lapcharoensap; Mihoko Bennett; Xiao Xu; Henry C Lee; Jochen Profit; Dmitry Dukhovny

doi:10.1038/s41372-023-01792-4

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

J Perinatol. 2024 Feb;44(2):224-230. doi: 10.1038/s41372-023-01792-4. Epub 2023 Oct 7.

Authors

Wannasiri Lapcharoensap¹, Mihoko Bennett^{2

3}, Xiao Xu⁴, Henry C Lee^{3

5}, Jochen Profit^{2

3}, Dmitry Dukhovny⁶

Affiliations

¹ Division of Neonatology, Department of Pediatrics, Oregon Health and Science University, Portland, OR, 97239, USA. lapcharo@ohsu.edu.
² Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, CA, 94305, USA.
³ California Perinatal Quality Care Collaborative, Stanford, CA, 94305, USA.
⁴ Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, New Haven, CT, 06520, USA.
⁵ Division of Neonatology, Department of Pediatrics, University of California San Diego, La Jolla, CA, 92093, USA.
⁶ Division of Neonatology, Department of Pediatrics, Oregon Health and Science University, Portland, OR, 97239, USA.

PMID: 37805592
DOI: 10.1038/s41372-023-01792-4

Abstract

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

Methods: 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.

Results: 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).

Conclusions: With the metrics used, we found no correlation between cost, quality, and outcomes in the care of VLBW infants.

MeSH terms

Birth Weight
California
Humans
Infant
Infant, Newborn
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal*
Retrospective Studies
Risk Factors

Abstract

MeSH terms

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