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Changes in hospital quality at hospitals serving black and hispanic newborns below 30 weeks’ gestation

Journal of Perinatology volume 42, pages 187–194 (2022)Cite this article

Subjects

Abstract

Objective

Examine whether the quality of Black and Hispanic serving (BHS) compared with not BHS (NBHS) NICUs has changed differentially over time.

Study design

Infants 24–29 weeks’ gestation born at U.S. Vermont Oxford Network centers (2006–2018) were studied. We calculated adjusted hospital quality scores as the predicted probabilities of composite in-hospital mortality and morbidities from a logistic model. We regressed hospital quality scores on birth year to estimate the linear temporal slope by BHS-serving status for hospitals within each Census division.

Results

Hospital quality improved similarly over time for BHS and NBHS hospitals across all divisions except West South Central where a mean change in the composite score was −18.8 (95% CI: −24.1, −13.5) for NBHS and −9.3 (95% CI: −14.1, −4.6) for BHS hospitals (p-value = 0.009).

Conclusion

Hospital quality improved similarly for BHS and NBHS hospitals across most divisions. Variation within and between divisions should be a focus for quality improvement.

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Acknowledgements

We are indebted to our colleagues who submit data to Vermont Oxford Network on behalf of infants and their families. Participating centers are listed in Appendix 1.

Financial disclosure

Horbar is an employee of Vermont Oxford Network and Edwards receives salary support from Vermont Oxford Network. The other authors have indicated they have no financial relationships relevant to this article to disclose.

Funding

Supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R03HD097305 to NSB and by the National Institute on Minority Health and Health Disparities under Award Number R01MD016012 to NSB.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA

    Nansi S. Boghossian & Marco Geraci

  2. MEMOTEF Department, Sapienza – University of Rome, Rome, Italy

    Marco Geraci

  3. Vermont Oxford Network, Burlington, Vermont, USA

    Erika M. Edwards & Jeffrey D. Horbar

  4. Department of Mathematics and Statistics, University of Vermont, Burlington, Vermont, USA

    Erika M. Edwards

  5. Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont, USA

    Erika M. Edwards & Jeffrey D. Horbar

Authors
  1. Nansi S. Boghossian
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  2. Marco Geraci
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  3. Erika M. Edwards
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  4. Jeffrey D. Horbar
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Contributions

NB participated in the conception and design of the study, including the analysis plan and in the interpretation of the data, wrote all drafts of the manuscript, and helped to revise it critically for important intellectual content. MG participated in designing the analysis plan, was responsible for the data management and data analysis, participated in the interpretation of the data, contributed to writing sections of the manuscript, and helped to revise the manuscript critically for important intellectual content. EE participated in the conception of the study and the interpretation of the data and revised the manuscript critically for important intellectual content. JH participated in the conception of the study, is the Chief Executive and Scientific Officer of the Vermont Oxford Network, from which the data were drawn, participated in the interpretation of the data, and helped to revise the manuscript critically for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Nansi S. Boghossian.

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The authors declare no competing interests.

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Boghossian, N.S., Geraci, M., Edwards, E.M. et al. Changes in hospital quality at hospitals serving black and hispanic newborns below 30 weeks’ gestation. J Perinatol 42, 187–194 (2022). https://doi.org/10.1038/s41372-021-01222-3

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  • DOI: https://doi.org/10.1038/s41372-021-01222-3

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