Neonatal Intensive Care Variation in Medicaid-Insured Newborns: A Population-Based Study.

摘要: Objective To assess the contribution of maternal and newborn characteristics to variation in neonatal intensive care use across regions hospitals. Study design This was a retrospective population-based live birth cohort infants insured by Texas Medicaid 2010-2014 with 2 subcohorts: very low weight (VLBW) singletons late preterm singletons. Crude risk-adjusted unit (NICU) admission rates, intermediate special days, imaging procedures were calculated Neonatal Intensive Care Regions (n = 21) hospitals (n = 100). Total payments calculated. Results Overall, 11.5% born, 91.7% VLBW, 37.6% born admitted NICU, receiving an average 2 days, 58 days, 5 days per inpatient episode $5231, $128 075, $10 837, respectively. There little VLBW NICU admissions but marked for days rates all cohorts. The decreased slightly after health risk adjustment. moderate substitution (Pearson r −0.63 P  Conclusions Across groups, poorly explained differences illness levels is likely indicate varying practice styles. Although “right” are uncertain, it unlikely that these patterns represent effective efficient care.