Changes in hospital quality at hospitals serving black and hispanic newborns below 30 weeks' gestation

Examine whether the quality of Black and Hispanic serving (BHS) compared with not BHS (NBHS) NICUs has changed differentially over time.

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.

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).

Hospital quality improved similarly for BHS and NBHS hospitals across most divisions. Variation within and between divisions should be a focus for quality improvement.