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Accounting for variation in length of NICU stay for extremely low birth weight infants

Journal of Perinatology volume 33, pages 872–876 (2013)Cite this article

Subjects

Abstract

Objective:

To develop a length of stay (LOS) model for extremely low birth weight (ELBW) infants.

Study Design:

We included infants from the California Perinatal Quality Care Collaborative with birth weight 401 to 1000 g who were discharged to home. Exclusion criteria were congenital anomalies, surgery and death. LOS was defined as days from admission to discharge. As patients who died or were transferred to lower level of care were excluded, we assessed correlation of hospital mortality rates and transfers to risk-adjusted LOS.

Results:

There were 2012 infants with median LOS 79 days (range 23 to 219). Lower birth weight, lack of antenatal steroids and lower Apgar score were associated with longer LOS. There was negligible correlation between risk-adjusted LOS and hospital mortality rates (r=0.0207) and transfer-out rates (r=0.121).

Conclusion:

Particularly because ELBW infants have extended hospital stays, identification of unbiased and informative risk-adjusted LOS for these infants is an important step in benchmarking best practice and improving efficiency in care.

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Acknowledgements

The project described was supported by Grant Number K23HD068400 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number UL1 TR000004.

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Authors and Affiliations

  1. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, CA, USA

    H C Lee, M V Bennett & J B Gould

  2. California Perinatal Quality Care Collaborative, Palo Alto, CA, USA

    H C Lee, M V Bennett & J B Gould

  3. California Department of Health Care Services, Sacramento, CA, USA

    J Schulman

  4. Department of Pediatrics, UCSF, San Francisco, CA, USA

    J Schulman

Authors
  1. H C Lee
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  2. M V Bennett
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  3. J Schulman
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  4. J B Gould
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Correspondence to H C Lee.

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The authors declare no conflict of interest.

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Author Contributions

All above-listed authors meet the following criteria: (1) Substantial contributions to conception and design, acquisition of data or analysis and interpretation of data. (2) Drafting the article or revising it critically for intellectual content; and (3) Final approval of the version to be published.

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Lee, H., Bennett, M., Schulman, J. et al. Accounting for variation in length of NICU stay for extremely low birth weight infants. J Perinatol 33, 872–876 (2013). https://doi.org/10.1038/jp.2013.92

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