Prioritization framework for improving the value of care for very low birth weight and very preterm infants.

TitlePrioritization framework for improving the value of care for very low birth weight and very preterm infants.
Publication TypeJournal Article
Year of Publication2021
AuthorsKing BC, Richardson T, Patel RM, Lee HC, Bamat NA, Hall M, Slaughter JL
JournalJ Perinatol
Date Published2021 Jun 01
ISSN1476-5543
Abstract

OBJECTIVE: Create a prioritization framework for value-based improvement in neonatal care.

STUDY DESIGN: A retrospective cohort study of very low birth weight (<1500 g) and/or very preterm (<32 weeks) infants discharged between 2012 and 2019 using the Pediatric Health Information System Database. Resource use was compared across hospitals and adjusted for patient-level differences. A prioritization score was created combining cost, patient exposure, and inter-hospital variability to rank resource categories.

RESULTS: Resource categories with the greatest cost, patient exposure, and inter-hospital variability were parenteral nutrition, hematology (lab testing), and anticoagulation (for central venous access and therapy), respectively. Based on our prioritization score, parenteral nutrition was identified as the highest priority overall.

CONCLUSIONS: We report the development of a prioritization score for potential value-based improvement in neonatal care. Our findings suggest that parenteral nutrition, central venous access, and high-volume laboratory and imaging modalities should be priorities for future comparative effectiveness and quality improvement efforts.

DOI10.1038/s41372-021-01114-6
Alternate JournalJ Perinatol
PubMed ID34075201