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Mortality among very low-birthweight infants in hospitals serving minority populations

Leo S Morales1, Douglas Staiger, Jeffrey D Horbar

  • 1University of California Los Angeles, USA. morales@rand.org

American Journal of Public Health
|November 24, 2005
PubMed

Insights

Hospitals serving a higher proportion of Black very low-birth-weight (VLBW) infants had higher neonatal mortality rates for all VLBW infants. This disparity may contribute to racial inequalities in infant mortality.

Area of Science:

  • Neonatal care
  • Public health
  • Health disparities

Background:

  • Racial disparities in infant mortality persist in the United States.
  • Very low-birth-weight (VLBW) infants are at high risk for neonatal mortality.
  • The role of hospital characteristics in VLBW infant outcomes requires further investigation.

Purpose of the Study:

  • To determine if the proportion of Black very low-birth-weight (VLBW) infants treated by a hospital is associated with neonatal mortality.
  • To examine this association for both Black and White VLBW infants.

Main Methods:

  • Analysis of medical records for 74,050 Black and White VLBW infants (501g-1500g) from 332 hospitals (1995-2000).
  • Hospitals with >35% Black VLBW infants were defined as "minority-serving."
  • Risk-adjusted neonatal mortality rates were compared between minority-serving and non-minority-serving hospitals.

Main Results:

  • Minority-serving hospitals had significantly higher risk-adjusted neonatal mortality rates compared to hospitals with <15% Black VLBW infants.
  • This increased mortality was observed for both White (OR=1.30) and Black (OR=1.29) VLBW infants.
  • The higher mortality in minority-serving hospitals was not explained by hospital or treatment variables.

Conclusions:

  • Minority-serving hospitals may offer lower quality of care to VLBW infants.
  • Disproportionate treatment of Black VLBW infants at minority-serving hospitals may exacerbate racial disparities in infant mortality.
  • Addressing quality of care at minority-serving hospitals is crucial for reducing infant mortality racial gaps.
Abstract

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