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Updated: Nov 4, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Quantifying the variation in neonatal transport referral patterns using network analysis.

Sarah N Kunz^1,2, Daniel Helkey^3,4, Marinka Zitnik⁵

¹Division of Newborn Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA, USA. skunz@bidmc.harvard.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association

|May 26, 2021

Summary

This summary is machine-generated.

Regionalized neonatal care improves outcomes. Neonatal transport networks vary by patient characteristics, indicating a need for multidimensional regionalization strategies for infants, especially preterm and surgical cases.

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Area of Science:

Neonatal medicine
Healthcare systems analysis
Network science

Background:

Regionalized care is crucial for reducing neonatal morbidity and mortality.
Understanding neonatal transport networks is key to optimizing care delivery.

Purpose of the Study:

To evaluate how patient characteristics correlate with quantitative differences in neonatal transport networks.
To assess the impact of infant attributes on the structure and efficiency of interhospital transfer systems.

Main Methods:

Retrospective analysis of prospectively collected data on neonatal transports (infants <28 days) in California (2008-2012).
Graph generation of bidirectional hospital transfers, stratified by patient attributes.
Comparison of standard network analysis metrics (density, centralization, efficiency, modularity).

Main Results:

Analysis of 34,708 acute transfers across 1594 routes and 271 hospitals.
Significant differences in network metrics (density, centralization, efficiency, modularity) were observed based on infant attributes.
Preterm and surgical patients exhibited greater regionalization compared to term or medically transported infants (p < 0.001).

Conclusions:

Neonatal interhospital transport networks are demonstrably different based on patient attributes.
Regionalization strategies must consider the multidimensional nature of these networks and patient-specific needs.