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Examining the effect of hospital-level factors on mortality of very low birth weight infants using multilevel modeling

Journal of Perinatology volume 31, pages 770–775 (2011)Cite this article

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Abstract

Objective:

The objective of this study was to examine the effect of hospital-level factors on mortality of very low birth weight infants using multilevel modeling.

Study Design:

This is a secondary data analysis of California maternal–infant hospital discharge data from 1997 to 2002. The study population was limited to singleton, non-anomalous, very low birth weight infants, who delivered in hospitals providing neonatal intensive care services (level-2 and higher). Hierarchical generalized linear modeling, also known as multilevel modeling, was used to adjust for individual-level confounders.

Result:

In a multilevel model, increasing hospital volume of very low birth weight deliveries was associated with lower odds of very low birth weight mortality. Characteristics of a particular hospital's obstetrical and neonatal services (the presence of residency and fellowship training programs and the availability of perinatal and neonatal services) had no independent effect.

Conclusion:

Using multilevel modeling, hospital volume of very low birth weight deliveries appears to be the primary driver of reduced mortality among very low birth weight infants.

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Acknowledgements

This research was supported, in part, by a grant from Perinatal Resources, Inc.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of California, Orange, CA, USA

    J H Chung

  2. Department of Health Services, School of Public Health, University of California, Los Angeles, CA, USA

    J H Chung, G F Kominski, A N Ortega & J Needleman

  3. Health Economics Resource Center, Center for Health Care, Evaluation, and Cooperative Studies Program, Veterans Affairs Palo Alto Health Care System, Menlo Park,, CA, USA

    C S Phibbs

  4. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    C S Phibbs

  5. Departments of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

    W J Boscardin

  6. Cedars-Sinai Medical Center and Burns Allen Research Institute, Los Angeles, CA, USA

    K D Gregory

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  1. J H Chung
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  2. C S Phibbs
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  3. W J Boscardin
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  4. G F Kominski
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  5. A N Ortega
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  6. K D Gregory
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  7. J Needleman
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Correspondence to J H Chung.

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The authors declare no conflict of interest.

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Chung, J., Phibbs, C., Boscardin, W. et al. Examining the effect of hospital-level factors on mortality of very low birth weight infants using multilevel modeling. J Perinatol 31, 770–775 (2011). https://doi.org/10.1038/jp.2011.29

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