TY - JOUR
T1 - Volume, size, professionals' specialization and nutrition management of NICUs and their association with treatment quality in VLBW infants
AU - Miedaner, Felix
AU - Langhammer, Kristina
AU - Enke, Christian
AU - Göpel, Wolfgang
AU - Kribs, Angela
AU - Nitzsche, Anika
AU - Riedel, Rainer
AU - Woopen, Christiane
AU - Kuntz, Ludwig
AU - Roth, Bernhard
N1 - Funding Information:
The study was funded by the German Federal Ministry of Education and Research (Grant No.: 01GY1152), participating hospitals received financial allowance
Publisher Copyright:
© 2017 Nature America, Inc., part of Springer Nature.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Objective: To assess the association of volume, size, the availability of highly-specialized professionals and nutrition management of NICUs with treatment quality among VLBW infants. Study design: A prospective multicenter study of 923 VLBW infants in 66 German NICUs, born between May and October 2013. Using multilevel modeling, we examined the association between the aforementioned organizational characteristics and treatment quality, measured via major morbidities (severe IVH, PVL, BPD, NEC, FIP, ROP, and discharge without severe complications) and medical process measures of VLBW infants. Results: After risk-adjustment and accounting for other NICU characteristics, infants in low-volume NICUs were at higher risk of IVH, ROP and PVL. However, the initial effect of volume on process measures (growth velocity, administration of antenatal steroids) disappeared. Conclusion: Volume can only partially explain differences in the treatment quality of VLBWs. The underlying organizational mechanisms should be considered to improve the quality of care.
AB - Objective: To assess the association of volume, size, the availability of highly-specialized professionals and nutrition management of NICUs with treatment quality among VLBW infants. Study design: A prospective multicenter study of 923 VLBW infants in 66 German NICUs, born between May and October 2013. Using multilevel modeling, we examined the association between the aforementioned organizational characteristics and treatment quality, measured via major morbidities (severe IVH, PVL, BPD, NEC, FIP, ROP, and discharge without severe complications) and medical process measures of VLBW infants. Results: After risk-adjustment and accounting for other NICU characteristics, infants in low-volume NICUs were at higher risk of IVH, ROP and PVL. However, the initial effect of volume on process measures (growth velocity, administration of antenatal steroids) disappeared. Conclusion: Volume can only partially explain differences in the treatment quality of VLBWs. The underlying organizational mechanisms should be considered to improve the quality of care.
UR - http://www.scopus.com/inward/record.url?scp=85040928843&partnerID=8YFLogxK
U2 - 10.1038/s41372-017-0036-0
DO - 10.1038/s41372-017-0036-0
M3 - Journal articles
C2 - 29371627
AN - SCOPUS:85040928843
SN - 0743-8346
VL - 38
SP - 402
EP - 410
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 4
ER -