Document Detail

Hospital volume and mortality of very low-birthweight infants in South America.
MedLine Citation:
PMID:  22352946     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the effects of hospital volume of very low-birthweight (VLBW) infants on in-hospital mortality of VLBW and very preterm birth (VPB) infants in South America.
DATA SOURCES/STUDY SETTING: Birth-registry data for infants born in 1982-2008 at VLBW or very preterm in 66 hospitals in Argentina, Brazil, and Chile.
DESIGN: Regression analyses that adjust for several individual-level demographic, socioeconomic, and health factors; hospital-level characteristics; and country-fixed effects are employed.
DATA COLLECTION/EXTRACTION METHODS: Physicians interviewed mothers before hospital discharge and abstracted hospital medical records using similar methods at all hospitals.
PRINCIPAL FINDINGS: Volume has significant nonlinear beneficial effects on VLBW and VPB in-hospital survival. The largest survival benefits--more than 80 percent decrease in mortality rates--are with volume increases from low to medium or medium-high levels (from ≤ 25 to 72 infants annually) with significantly lower incremental benefits thereafter. The cumulative volume effects are maximized at the 121-144 annual VLBW infant range--about 90 percent decrease in mortality rates compared to <25 VLBW infants annually.
CONCLUSIONS: Increasing the access of pregnancies at-risk of VLBW and VPB to medium- or high-volume hospitals up to 144 VLBW infants per year may substantially improve in-hospital infant survival in the study countries.
George L Wehby; Jorge Lopez-Camelo; Eduardo E Castilla
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-02-21
Journal Detail:
Title:  Health services research     Volume:  47     ISSN:  1475-6773     ISO Abbreviation:  Health Serv Res     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-06     Completed Date:  2012-09-20     Revised Date:  2014-09-21    
Medline Journal Info:
Nlm Unique ID:  0053006     Medline TA:  Health Serv Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1502-21     Citation Subset:  IM    
Copyright Information:
© Health Research and Educational Trust.
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MeSH Terms
Area Under Curve
Argentina / epidemiology
Brazil / epidemiology
Chile / epidemiology
Hospital Mortality*
Infant Mortality*
Infant, Newborn
Infant, Very Low Birth Weight*
Interviews as Topic
ROC Curve
Regression Analysis
Grant Support
1R03 DE018394/DE/NIDCR NIH HHS; 5R03 TW 008110/TW/FIC NIH HHS; R03 DE018394/DE/NIDCR NIH HHS; R03 DE018394-02/DE/NIDCR NIH HHS; R03 TW008110/TW/FIC NIH HHS; R03 TW008110-01A2/TW/FIC NIH HHS

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