Abstract
Statistical analysis of birthweight distribution and weight specific neonatal mortality rates (NMR) revealed that 62% of a 31% reduction in NMR between 1974 and 1978 in WV was due to improved survival of < 2500 gm infants. These findings suggest that the observed reduction in NMR is due to increased access to neonatal intensive care rather than the improved socio-economic factors reflected in birthweight distribution. To further test this hypothesis we surmised that low birthweight infants born in hospitals with higher referral rates would experience lower NMR than infants born in hospitals with low referral rates.
Data sources include infant referral data to all perinatal centers, and matched birth and death certificates. All 2,194 infants weighing between 1001-2500 gms born in WV hospitals in 1977 and 1978 were selected for special study.
Analysis confirms that hospitals with higher referral rates have lower NMR among 1001-2500 gm infants. 16.4 deaths per 1,000 infants born in hospitals which referred below the mean may be attributed to the infants having been born in this group. When hospitals were grouped by number of specialists associated it was learned that secondary hospitals referred at a rate 50% below that of primary hospitals and NMR in secondary hospitals was 13% higher than in primary hospitals.
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Parkinson, R., Garland, B., Myerberg, D. et al. 486 REFERRAL RATES AND NEONATAL OUTCOME AMONG COMMUNITY HOSPITAL BORN INFANTS IN A STATEWIDE PERINATAL INTENSIVE CARE NETWORK. Pediatr Res 15 (Suppl 4), 521 (1981). https://doi.org/10.1203/00006450-198104001-00499
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DOI: https://doi.org/10.1203/00006450-198104001-00499