| Variations in Definitions of Mortality Have Little Influence on Neonatal Intensive Care Unit Performance Ratings. | |
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MedLine Citation:
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PMID: 22854328 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To measure the influence of varying mortality time frames on performance rankings among regional neonatal intensive care units (NICUs) in a large state. STUDY DESIGN: We performed a cross-sectional data analysis of very low birth weight infants receiving care at 24 level 3 NICUs. We tested the effect of 4 definitions of mortality: (1) death between admission and end of birth hospitalization or up to 366 days; (2) death between 12 hours of age and the end of birth hospitalization or up to 366 days; (3) death between admission and 28 days; and (4) death between 12 hours of age and 28 days. NICUs were ranked by quantifying their deviation from risk-adjusted expected mortality and dividing them into 3 tiers: top 6, bottom 6, and in between. RESULTS: There was wide interinstitutional variation in risk-adjusted mortality for each definition (observed minus expected z-score range, -6.08 to 3.75). However, mortality-based NICU rankings and classification into performance tiers were very similar for all institutions in each of our time frames. Among all 4 definitions, NICU rank correlations were high (>0.91). Few NICUs changed relative to a neighboring tier with changes in definitions, and none changed by more than one tier. CONCLUSION: The time frame used to ascertain mortality had little effect on comparative NICU performance. |
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Authors:
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Jochen Profit; Jeffrey B Gould; David Draper; John A F Zupancic; Marc A Kowalkowski; Lechauncy Woodard; Kenneth Pietz; Laura A Petersen |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-31 |
Journal Detail:
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Title: The Journal of pediatrics Volume: - ISSN: 1097-6833 ISO Abbreviation: J. Pediatr. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-8-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Pediatrics, Baylor College of Medicine; Texas Children's Hospital, Houston, TX; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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