分娩医院的护理质量导致低风险新生儿结局的种族差异

Kristine Schmitz, L. Kleinman
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引用次数: 0

摘要

方法利用2010-2014年生命统计数据和出院数据,Glazer等确定低并发症风险新生儿。考虑到医院的固定影响、个人(如社会人口统计学、母亲健康)和医院(如产生量、公共保险分娩的百分比)的特点,各种逻辑回归模型估计了调整后的ORs并计算了标准化比率。使用联合委员会的指标,结果包括中度和严重的意外新生儿并发症。根据结果(预期并发症与观察到的并发症之比乘以总体平均发生率)对医院进行排名。这项复杂的分析评估了对选择结果(全部、中度、重度)的敏感性,并考虑了所有医院之间和质量等级五分位数内的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quality of care in the delivery hospital contributes to racial disparities in outcomes for low-risk newborns
Methods Using 2010–2014 vital statistics and discharge data, Glazer et al identified births at low risk for complications. Various logistic regression models estimated adjusted ORs and calculated standardised rates, accounting for hospital fixed effects, individual (eg, sociodemographic, mother’s health) and hospital (eg, delivery volume, per cent of deliveries publicly insured) characteristics. Outcomes include moderate and severe unexpected newborn complications, using the Joint Commission metric. Hospitals were ranked by outcomes (ratio of expected to observed complications multiplied by overall average rate). The sophisticated analysis assessed sensitivity to choice of outcomes (all, moderate, severe) and considered disparities across all hospitals and within tertiles of quality rank.
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