服务于胎龄小于 30 周的黑人和西班牙裔新生儿的医院的医院质量变化。
Changes in hospital quality at hospitals serving black and hispanic newborns below 30 weeks' gestation.
机构信息
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
MEMOTEF Department, Sapienza - University of Rome, Rome, Italy.
出版信息
J Perinatol. 2022 Feb;42(2):187-194. doi: 10.1038/s41372-021-01222-3. Epub 2021 Oct 2.
OBJECTIVE
Examine whether the quality of Black and Hispanic serving (BHS) compared with not BHS (NBHS) NICUs has changed differentially over time.
STUDY DESIGN
Infants 24-29 weeks' gestation born at U.S. Vermont Oxford Network centers (2006-2018) were studied. We calculated adjusted hospital quality scores as the predicted probabilities of composite in-hospital mortality and morbidities from a logistic model. We regressed hospital quality scores on birth year to estimate the linear temporal slope by BHS-serving status for hospitals within each Census division.
RESULTS
Hospital quality improved similarly over time for BHS and NBHS hospitals across all divisions except West South Central where a mean change in the composite score was -18.8 (95% CI: -24.1, -13.5) for NBHS and -9.3 (95% CI: -14.1, -4.6) for BHS hospitals (p-value = 0.009).
CONCLUSION
Hospital quality improved similarly for BHS and NBHS hospitals across most divisions. Variation within and between divisions should be a focus for quality improvement.
目的
考察与非黑人服务（NBHS）相比，黑人服务（BHS）NICU 的质量是否随时间发生了不同的变化。
研究设计
本研究对美国佛蒙特州牛津网络中心（2006-2018 年）出生的 24-29 周龄婴儿进行了研究。我们通过逻辑回归模型计算了综合住院死亡率和发病率的预测概率，以确定医院质量评分。我们将医院质量评分回归到出生年份，以估计每个人口普查分区内 BHS 服务医院的线性时间斜率。
结果
除了西南中部地区外，BHS 和 NBHS 医院的医院质量在所有地区都随时间相似地提高，在 NBHS 中，复合评分的平均变化为-18.8（95%CI：-24.1，-13.5），BHS 医院为-9.3（95%CI：-14.1，-4.6）（p 值=0.009）。
结论
BHS 和 NBHS 医院的医院质量在大多数地区都相似地提高。各分区内和分区之间的差异应成为质量改进的重点。
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