A risk-adjusted, composite outcomes score and resource utilization metrics for very low-birth-weight infants

JAMA Pediatrics
Joseph W KaempfGary L Grunkemeier

Abstract

It is difficult for neonatal intensive care units (NICUs) to determine the overall efficacy of multiple continuous quality improvement (CQI) projects aimed at reducing very low-birth-weight (VLBW) infant morbidities. It is challenging to know whether a NICU is becoming more proficient, and it is not usually apparent whether concurrent resource use is changing. To develop a risk-adjusted composite score of the major morbidities in VLBW infants and a companion metric that accounts for resource use to enhance the ability to measure overall progress in CQI and to identify proficient NICUs. This retrospective investigation used individual patient-level demographic and outcomes data from 8 NICUs who were long term CQI collaborators within the Vermont Oxford Network, a large international quality improvement organization dedicated to improving the care of premature infants. Study participants were infants who weighed 401 to 1500 g born from January 1, 2000, through December 31, 2011, at each of the 8 participating NICUs. Risk-adjusted, composite VLBW infant morbidity and resource utilization score. A total of 15,961 infants (mean [SD] gestational age, 28.2 [3.0] weeks; mean [SD] birth weight, 1020 [306] g) were analyzed. Concurrent wi...Continue Reading

Citations

Mar 21, 2016·The Journal of Pediatrics·An N MassaroUNKNOWN Children's Hospital Neonatal Consortium
Mar 27, 2016·The Journal of Pediatrics·Reese H Clark, Alan R Spitzer
Feb 17, 2017·Journal of Perinatology : Official Journal of the California Perinatal Association·J W KaempfN Tipping
Mar 18, 2017·Journal of Neonatal-perinatal Medicine·R K HustonH S Cohen
Jan 5, 2018·Archives of Disease in Childhood. Fetal and Neonatal Edition·Joseph W KaempfMichael Dunn
Jan 24, 2020·Pediatric Research·Dominique HaumontWillem Aelvoet
Oct 29, 2020·Archives of Disease in Childhood. Fetal and Neonatal Edition·Joseph KaempfMichael Dunn
Aug 15, 2017·Clinics in Perinatology·Timmy HoDmitry Dukhovny

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