Variation in complication rates for term newborns in Florida

(HealthDay)—There is considerable variation in hospital total unexpected complication rates among newborns in Florida, according to a study published online Feb. 10 in Pediatrics.

Yuri V. Sebastião, Ph.D., M.P.H., from the University of South Florida in Tampa, and colleagues conducted a population-based retrospective cohort study of linked birth certificate and hospital discharge records for a population of 1,604,774 term, singleton livebirths in 124 hospitals from 2004 to 2013. Using a published algorithm, the authors identified severe and moderate complications.

The researchers observed variation in hospital total complication rates from 6.7 to 98.6 per 1,000 births. There was no association between severe and moderate complication rates by hospital. Medically indicated early-term delivery, no prenatal care, nulliparity, pre-pregnancy obesity, tobacco use, and delivery in southern Florida hospitals were leading risk factors for complications. For severe and moderate complication rates, hospital factors, such as geographic location, level of care, or birth volume, and Medicaid births percentage explained 35 and 27.8 percent of variation, respectively. An additional 6 percent of variation in severe complication rates was explained by individual factors. The hospital factors that contributed to severe and moderate complications were driven by different complication subcategories (such as infections and hospital transfers).

"The high proportion of variation explained by hospital factors suggests potential opportunities for improvement, and identifying specific complication categories may provide focus areas," the authors write.

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