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Composite neonatal morbidity indicators using hospital discharge data: A systematic review.
Elodie Lebreton1,2,3, Catherine Crenn-Hébert3,4, Claudie Menguy3,5
1Data Science and Analytics Department, SESAN, Paris, France.
Paediatric and Perinatal Epidemiology
|March 25, 2020
Summary
Defining neonatal morbidity is crucial for research, but current indicators lack standardization. This review highlights the need for consistent outcome measures to improve comparisons and synthesis of findings on infant health.
Area of Science:
- Neonatal research
- Public health surveillance
- Healthcare informatics
Background:
- Neonatal morbidity significantly impacts long-term health outcomes.
- Lack of a standardized definition and large datasets hinder research progress.
- Composite neonatal morbidity indicators from hospital discharge data are underutilized.
Purpose of the Study:
- To review composite neonatal morbidity indicators derived from routine hospital discharge data.
- To inform initiatives for defining standard research outcomes.
- To identify heterogeneity in current indicators and guide future standardization efforts.
Main Methods:
- Systematic literature search of PubMed using keywords: "morbidity," "neonatal," and "hospital discharge data."
- Inclusion criteria: studies using composite indicators from hospital discharge data, excluding condition-specific indicators.
- Data extraction: target population, objectives, component morbidities, codes, validation methods, and prevalence.
Main Results:
- Seventeen studies met inclusion criteria, focusing on all infants, low-/moderate-risk, or very preterm (VPT) infants.
- Indicator components and diagnosis codes showed significant variation, especially for all and low-/moderate-risk infants.
- Prevalence rates varied widely: 4.6%-9.0% (all), 0.4%-8.0% (low-/moderate-risk), and 17.8%-61.0% (VPT).
Conclusions:
- Existing neonatal morbidity indicators derived from hospital discharge data are heterogeneous, limiting inter-study comparisons.
- There is a critical need for standardized neonatal outcome measures for effective benchmarking and research synthesis.
- Standardization will enhance the reliability and comparability of research on neonatal health outcomes.
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