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Levels of neonatal care among birth facilities in 20 states and other jurisdictions: CDC levels of care assessment toolSM (CDC LOCATeSM)

Journal of Perinatology volume 43, pages 484–489 (2023)Cite this article

Subjects

Abstract

Objective

Describe discrepancies between facilities’ self-reported level of neonatal care and Centers for Disease Control and Prevention Levels of Care Assessment ToolSM (CDC LOCATeSM)-assessed level.

Study design

CDC LOCATeSM data from 765 health facilities in the United States, including 17 states, one territory, one large multi-state hospital system, and one perinatal region within a state, was collected between 2016 and 2021 for this cross-sectional analysis.

Result

Among 721 facilities that self-reported level of neonatal care, 33.1% had discrepancies between their self-reported level and their LOCATeSM-assessed level. Among facilities with discrepancies, 75.3% self-reported a higher level of neonatal care than their LOCATeSM-assessed level. The most common elements contributing to discrepancies were limited specialty and subspecialty staffing, such as neonatology or neonatal surgery.

Conclusion

Results highlight opportunities for jurisdictions to engage with facilities, health systems, and partners about levels of neonatal care, and to collaborate to promote standardized systems of risk-appropriate care.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to data being owned by participating jurisdictions, but are available from the corresponding author on reasonable request.

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Acknowledgements

We want to thank the implementing agencies responsible for CDC LOCATeSM in each jurisdiction that provided CDC LOCATeSM data included in this analysis. Any published findings and conclusions do not necessarily represent the official position of the jurisdictions that participated in CDC LOCATeSM. This project was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education through an interagency agreement between U.S. Department of Energy and the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Jennifer L. Wilkers, Carla L. DeSisto, Alexander C. Ewing, Sabrina A. Madni, Jennifer L. Beauregard, Mary D. Brantley & David A. Goodman

  2. Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA

    Jennifer L. Wilkers & Sabrina A. Madni

  3. U.S. Public Health Service Commissioned Corps, Rockville, MD, USA

    Jennifer L. Beauregard

Authors
  1. Jennifer L. Wilkers
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  2. Carla L. DeSisto
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  3. Alexander C. Ewing
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  4. Sabrina A. Madni
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  5. Jennifer L. Beauregard
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  6. Mary D. Brantley
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  7. David A. Goodman
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Contributions

JW conceptualized and designed the work; acquired, analyzed, and interpreted the data; and drafted the manuscript. CD replicated the analysis and revised the manuscript critically for important intellectual content. AE and DG conceptualized and designed the work; acquired the data; and revised the manuscript critically for important intellectual content. SM, JB, and MB revised the manuscript critically for important intellectual content.

Corresponding author

Correspondence to Jennifer L. Wilkers.

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The authors declare no competing interests.

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Wilkers, J.L., DeSisto, C.L., Ewing, A.C. et al. Levels of neonatal care among birth facilities in 20 states and other jurisdictions: CDC levels of care assessment toolSM (CDC LOCATeSM). J Perinatol 43, 484–489 (2023). https://doi.org/10.1038/s41372-022-01512-4

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