在整个卫生系统中非常早产婴儿的结果
Jeannette A Rogowski1, Lucy Greenberg2, Erika M Edwards2,3,4
1College of Health and Human Development, The Pennsylvania State University, University Park.
JAMA network open
|June 2, 2025
概括
在美国卫生系统中,对非常早产婴儿的护理存在差异. 2个百分点的死亡率差异和12天的逗留时间变化突出了新生儿重症监护病房质量改善的机会.
科学领域:
- 新生儿医学 新生儿医学
- 医疗保健服务研究 医疗服务研究
- 儿科 儿科 儿科
背景情况:
- 由于整合,美国大多数非常早产婴儿在多医院医疗系统内接受护理.
- 这些系统中非常早产婴儿的结果和停留时间变化的程度在很大程度上是未知的.
研究的目的:
- 评估非常早产 (妊娠年龄24-29周) 婴儿在卫生系统内和卫生系统内的死亡率和停留时间的变化.
主要方法:
- 一项横截面研究分析了2021年1月至2022年12月间佛蒙特牛津网络中的224个美国卫生系统的数据.
- 包括38,501名非常早产婴儿接受新生儿重症监护室 (NICU) 护理.
- 多层次的物流和线性模型估计了调整后的死亡率和停留时间.
主要成果:
- 性能最高的四分之一系统的平均调整后死亡率为7.8%,而性能最低的四分之一系统的平均调整后死亡率为9.8%.
- 幸存婴儿的平均调整停留时间在表现最高的四分位数中从78天到最低的90天不等.
- 在系统四分位数之间观察到死亡率的2个百分点差异和停留时间的12天差异.
结论:
- 在美国卫生系统中,非常早产婴儿的死亡率和逗留时间存在显著的,可能具有临床意义的变化.
- 卫生系统有机会提高系统层面的护理质量,旨在减少死亡率和资源利用.
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