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How are neonatal intensive care units (NICUs) being utilized in the Kaiser Permanente Southern California health care system? A new report investigates.
Neonatal intensive care unit (NICU) utilization hasn’t been fully studied. A report in JAMA Network Open examines the trends in a large integrated health care system.1
Investigators used data from electronic medical records from the Kaiser Permanente Southern California health care system. The study’s participants included every woman who gave birth in a Kaiser Permanente Southern California hospital and her newborn from January 2010 to December 2018. The rates of NICU admission, NICU patient-days, readmission rates, and mortality rates were measured in the total population; newborns with gestational age (GA) 35 weeks or greater and a birth weight (BW) 2000 grams or more (high GA and BW group); and within the remaining newborns (low GA and BW group).
During the study period, there were 320,340 births. During the period, the risk-adjusted NICU admission rate decreased from an average of 14.5% to 10.9%. Ninety-two percent of the change was linked with changes in the care given to newborns in the high GA and BW group. Overall, the number of risk-adjusted NICU patient-days per birth decreased from an average of 1.50 patient-days to 1.40 patient-days and 70% of the change was in newborns in the high GA and BW group. There was no change in the unadjusted 30-day readmission rates and mortality rates.
The researchers concluded that NICU utilization had decreased over the study period, but it did not lead to an increase in readmissions or mortality. They said that further investigation into the effect of quality improvement programs on NICU utilization are merited.
1. Braun D, Braun E, Chiu V et al. Trends in neonatal intensive care unit utilization in a large integrated health care system. JAMA Netw Open. 2020;3(6):e205239. doi:10.1001/jamanetworkopen.2020.5239