Royal Hospital for Women, National Perinatal Epidemiology and Statistic Unit, University of New South Wales, Randwick, Australia.
Division of Neonatology and Health Research Institute, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain.
Semin Fetal Neonatal Med. 2021 Feb;26(1):101196. doi: 10.1016/j.siny.2021.101196. Epub 2021 Jan 21.
Collaboration and cooperation of clinicians and neonatal units at regional, national, and international levels are key features of many networks or systems that aim to improve neonatal outcomes. Network performance is typically assessed by comparing individual, unit-level outcomes. In this paper, we provide insight into another dimension, i.e., inter-center outcome variation in 10 national/regional neonatal collaborations from 11 high-income countries. We illustrate the use of coefficients of variation for evaluation of mortality and a composite outcome of mortality, severe neurological injury, treated retinopathy of prematurity, and bronchopulmonary dysplasia, as a measure of inter-center variation. These inter-center variation estimates could help to identify areas of opportunities and challenges for each country/region; they also provide "macro"-level evaluations that can be useful for clinicians, administrators, managers and policy makers.
临床医生和新生儿单位在区域、国家和国际各级的协作与合作是许多旨在改善新生儿结局的网络或系统的关键特征。网络性能通常通过比较个体、单位水平的结果来评估。在本文中，我们提供了另一个维度的见解，即来自 11 个高收入国家的 10 个国家/地区新生儿合作中心之间的中心间结局差异。我们说明了使用变异系数来评估死亡率和死亡率、严重神经损伤、治疗性早产儿视网膜病变和支气管肺发育不良的复合结局作为中心间变异的度量。这些中心间变异估计值有助于确定每个国家/地区的机会和挑战领域；它们还提供了可以供临床医生、管理人员、经理和政策制定者使用的“宏观”水平评估。
