Hospital Volume and Mortality of Very Low-Birthweight Infants in South America

Autores
Wehby, George; López Camelo, Jorge Santiago; Castilla, Eduardo Enrique
Año de publicación
2012
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objective To assess the effects of hospital volume of very low-birthweight (VLBW) infants on in-hospital mortality of VLBW and very preterm birth (VPB) infants in South America. Data Sources/Study Setting Birth-registry data for infants born in 1982-2008 at VLBW or very preterm in 66 hospitals in Argentina, Brazil, and Chile. Design Regression analyses that adjust for several individual-level demographic, socioeconomic, and health factors; hospital-level characteristics; and country-fixed effects are employed. Data Collection/Extraction Methods Physicians interviewed mothers before hospital discharge and abstracted hospital medical records using similar methods at all hospitals. Principal Findings Volume has significant nonlinear beneficial effects on VLBW and VPB in-hospital survival. The largest survival benefits - more than 80 percent decrease in mortality rates - are with volume increases from low to medium or medium-high levels (from 25 to 72 infants annually) with significantly lower incremental benefits thereafter. The cumulative volume effects are maximized at the 121-144 annual VLBW infant range - about 90 percent decrease in mortality rates compared to <25 VLBW infants annually. Conclusions Increasing the access of pregnancies at-risk of VLBW and VPB to medium- or high-volume hospitals up to 144 VLBW infants per year may substantially improve in-hospital infant survival in the study countries.
Fil: Wehby, George. University of Iowa; Estados Unidos
Fil: López Camelo, Jorge Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Castilla, Eduardo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán". Centro Nacional de Genética Médica; Argentina. Fundación Oswaldo Cruz; Brasil
Materia
CHILD AND ADOLESCENT HEALTH
HOSPITALS
MATERNAL AND PERINATAL CARE AND OUTCOMES
PEDIATRICS
QUALITY OF CARE/PATIENT SAFETY (MEASUREMENT)
REFERRALS AND REFERRAL NETWORKS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/95486
Acceder
id CONICETDig_316efa9552a011bcf6808206e18e12d0
oai_identifier_str oai:ri.conicet.gov.ar:11336/95486
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Hospital Volume and Mortality of Very Low-Birthweight Infants in South AmericaWehby, GeorgeLópez Camelo, Jorge SantiagoCastilla, Eduardo EnriqueCHILD AND ADOLESCENT HEALTHHOSPITALSMATERNAL AND PERINATAL CARE AND OUTCOMESPEDIATRICSQUALITY OF CARE/PATIENT SAFETY (MEASUREMENT)REFERRALS AND REFERRAL NETWORKShttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Objective To assess the effects of hospital volume of very low-birthweight (VLBW) infants on in-hospital mortality of VLBW and very preterm birth (VPB) infants in South America. Data Sources/Study Setting Birth-registry data for infants born in 1982-2008 at VLBW or very preterm in 66 hospitals in Argentina, Brazil, and Chile. Design Regression analyses that adjust for several individual-level demographic, socioeconomic, and health factors; hospital-level characteristics; and country-fixed effects are employed. Data Collection/Extraction Methods Physicians interviewed mothers before hospital discharge and abstracted hospital medical records using similar methods at all hospitals. Principal Findings Volume has significant nonlinear beneficial effects on VLBW and VPB in-hospital survival. The largest survival benefits - more than 80 percent decrease in mortality rates - are with volume increases from low to medium or medium-high levels (from 25 to 72 infants annually) with significantly lower incremental benefits thereafter. The cumulative volume effects are maximized at the 121-144 annual VLBW infant range - about 90 percent decrease in mortality rates compared to <25 VLBW infants annually. Conclusions Increasing the access of pregnancies at-risk of VLBW and VPB to medium- or high-volume hospitals up to 144 VLBW infants per year may substantially improve in-hospital infant survival in the study countries.Fil: Wehby, George. University of Iowa; Estados UnidosFil: López Camelo, Jorge Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Castilla, Eduardo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán". Centro Nacional de Genética Médica; Argentina. Fundación Oswaldo Cruz; BrasilWiley Blackwell Publishing, Inc2012-08info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/mswordapplication/pdfhttp://hdl.handle.net/11336/95486Wehby, George; López Camelo, Jorge Santiago; Castilla, Eduardo Enrique; Hospital Volume and Mortality of Very Low-Birthweight Infants in South America; Wiley Blackwell Publishing, Inc; Health Services Research; 47; 4; 8-2012; 1502-15210017-9124CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2012.01383.xinfo:eu-repo/semantics/altIdentifier/doi/10.1111/j.1475-6773.2012.01383.xinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:47:15Zoai:ri.conicet.gov.ar:11336/95486instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:47:15.459CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
title Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
spellingShingle Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
Wehby, George
CHILD AND ADOLESCENT HEALTH
HOSPITALS
MATERNAL AND PERINATAL CARE AND OUTCOMES
PEDIATRICS
QUALITY OF CARE/PATIENT SAFETY (MEASUREMENT)
REFERRALS AND REFERRAL NETWORKS
title_short Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
title_full Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
title_fullStr Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
title_full_unstemmed Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
title_sort Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
dc.creator.none.fl_str_mv Wehby, George
López Camelo, Jorge Santiago
Castilla, Eduardo Enrique
author Wehby, George
author_facet Wehby, George
López Camelo, Jorge Santiago
Castilla, Eduardo Enrique
author_role author
author2 López Camelo, Jorge Santiago
Castilla, Eduardo Enrique
author2_role author
author
dc.subject.none.fl_str_mv CHILD AND ADOLESCENT HEALTH
HOSPITALS
MATERNAL AND PERINATAL CARE AND OUTCOMES
PEDIATRICS
QUALITY OF CARE/PATIENT SAFETY (MEASUREMENT)
REFERRALS AND REFERRAL NETWORKS
topic CHILD AND ADOLESCENT HEALTH
HOSPITALS
MATERNAL AND PERINATAL CARE AND OUTCOMES
PEDIATRICS
QUALITY OF CARE/PATIENT SAFETY (MEASUREMENT)
REFERRALS AND REFERRAL NETWORKS
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objective To assess the effects of hospital volume of very low-birthweight (VLBW) infants on in-hospital mortality of VLBW and very preterm birth (VPB) infants in South America. Data Sources/Study Setting Birth-registry data for infants born in 1982-2008 at VLBW or very preterm in 66 hospitals in Argentina, Brazil, and Chile. Design Regression analyses that adjust for several individual-level demographic, socioeconomic, and health factors; hospital-level characteristics; and country-fixed effects are employed. Data Collection/Extraction Methods Physicians interviewed mothers before hospital discharge and abstracted hospital medical records using similar methods at all hospitals. Principal Findings Volume has significant nonlinear beneficial effects on VLBW and VPB in-hospital survival. The largest survival benefits - more than 80 percent decrease in mortality rates - are with volume increases from low to medium or medium-high levels (from 25 to 72 infants annually) with significantly lower incremental benefits thereafter. The cumulative volume effects are maximized at the 121-144 annual VLBW infant range - about 90 percent decrease in mortality rates compared to <25 VLBW infants annually. Conclusions Increasing the access of pregnancies at-risk of VLBW and VPB to medium- or high-volume hospitals up to 144 VLBW infants per year may substantially improve in-hospital infant survival in the study countries.
Fil: Wehby, George. University of Iowa; Estados Unidos
Fil: López Camelo, Jorge Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Castilla, Eduardo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán". Centro Nacional de Genética Médica; Argentina. Fundación Oswaldo Cruz; Brasil
description Objective To assess the effects of hospital volume of very low-birthweight (VLBW) infants on in-hospital mortality of VLBW and very preterm birth (VPB) infants in South America. Data Sources/Study Setting Birth-registry data for infants born in 1982-2008 at VLBW or very preterm in 66 hospitals in Argentina, Brazil, and Chile. Design Regression analyses that adjust for several individual-level demographic, socioeconomic, and health factors; hospital-level characteristics; and country-fixed effects are employed. Data Collection/Extraction Methods Physicians interviewed mothers before hospital discharge and abstracted hospital medical records using similar methods at all hospitals. Principal Findings Volume has significant nonlinear beneficial effects on VLBW and VPB in-hospital survival. The largest survival benefits - more than 80 percent decrease in mortality rates - are with volume increases from low to medium or medium-high levels (from 25 to 72 infants annually) with significantly lower incremental benefits thereafter. The cumulative volume effects are maximized at the 121-144 annual VLBW infant range - about 90 percent decrease in mortality rates compared to <25 VLBW infants annually. Conclusions Increasing the access of pregnancies at-risk of VLBW and VPB to medium- or high-volume hospitals up to 144 VLBW infants per year may substantially improve in-hospital infant survival in the study countries.
publishDate 2012
dc.date.none.fl_str_mv 2012-08
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/95486
Wehby, George; López Camelo, Jorge Santiago; Castilla, Eduardo Enrique; Hospital Volume and Mortality of Very Low-Birthweight Infants in South America; Wiley Blackwell Publishing, Inc; Health Services Research; 47; 4; 8-2012; 1502-1521
0017-9124
CONICET Digital
CONICET
url http://hdl.handle.net/11336/95486
identifier_str_mv Wehby, George; López Camelo, Jorge Santiago; Castilla, Eduardo Enrique; Hospital Volume and Mortality of Very Low-Birthweight Infants in South America; Wiley Blackwell Publishing, Inc; Health Services Research; 47; 4; 8-2012; 1502-1521
0017-9124
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2012.01383.x
info:eu-repo/semantics/altIdentifier/doi/10.1111/j.1475-6773.2012.01383.x
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/msword
application/pdf
dc.publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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