ArticlePediatrics2016
The Association of Level of Care With NICU Quality.
Article in Pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed.
- Article
- The association of NICU capacity strain with neonatal mortality and morbidity.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Neonatologist staffing is related to the inter-hospital variation of risk-adjusted mortality of very low birth weight infants in Korea.Scientific reports · 2024Article
- Hospital performance evaluation indicators: a scoping review.BMC health services research · 2024Article
- Hospital-Level NICU Capacity, Utilization, and 30-Day Outcomes in Texas.JAMA network open · 2024Article
- Quality, outcome, and cost of care provided to very low birth weight infants in California.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Maternal and neonatal risk-appropriate care: gaps, strategies, and areas for further research.Journal of perinatology : official journal of the California Perinatal Association · 2023Review
- Measuring quality of care in moderate and late preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Evaluating Care in Safety Net Hospitals: Clinical Outcomes and Neonatal Intensive Care Unit Quality of Care in California.The Journal of pediatrics · 2022Article
- End-of-Life Decision-Making in Pediatric and Neonatal Intensive Care Units in Croatia-A Focus Group Study among Nurses and Physicians.Medicina (Kaunas, Lithuania) · 2022Article
- Birth Volume and Geographic Distribution of US Hospitals With Obstetric Services From 2010 to 2018.JAMA network open · 2021Article
- Quality of Care in US NICUs by Race and Ethnicity.Pediatrics · 2021Article
- Access to risk-appropriate hospital care and disparities in neonatal outcomes in racial/ethnic groups and rural-urban populations.Seminars in perinatology · 2021Review
- Multilevel social factors and NICU quality of care in California.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Development and use of an adjusted nurse staffing metric in the neonatal intensive care unit.Health services research · 2020Article
- Disparities in Health Care-Associated Infections in the NICU.American journal of perinatology · 2020Article
- Impact of neonatologist availability on preterm survival without morbidities.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
- Never judge a book by its cover: how NICU evaluators reach conclusions about quality of care.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
- Comparison of state risk-appropriate neonatal care policies with the 2012 AAP policy statement.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
- Volume, size, professionals' specialization and nutrition management of NICUs and their association with treatment quality in VLBW infants.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundRegionalized care delivery purportedly optimizes care to vulnerable very low birth weight (VLBW; <1500 g) infants. However, a comprehensive assessment of quality of care delivery across different levels of NICUs has not been done.
methodsWe conducted a cross-sectional analysis of 21,051 VLBW infants in 134 California NICUs. NICUs designated their level of care according to 2012 American Academy of Pediatrics guidelines. We assessed quality of care delivery via the Baby-MONITOR, a composite indicator, which combines 9 risk-adjusted measures of quality. Baby-MONITOR scores are measured as observed minus expected performance, expressed in standard units with a mean of 0 and an SD of 1.
resultsWide variation in Baby-MONITOR scores exists across California (mean [SD] 0.18 (1.14), range -2.26 to 3.39). However, level of care was not associated with overall quality scores. Subcomponent analysis revealed trends for higher performance of Level IV NICUs on several process measures, including antenatal steroids and any human milk feeding at discharge, but lower scores for several outcomes including any health care associated infection, pneumothorax, and growth velocity. No other health system or organizational factors including hospital ownership, neonatologist coverage, urban or rural location, and hospital teaching status, were significantly associated with Baby-MONITOR scores.
conclusionsThe comprehensive assessment of the effect of level of care on quality reveals differential opportunities for improvement and allows monitoring of efforts to ensure that fragile VLBW infants receive care in appropriate facilities.
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