Universität zu Köln

Miedaner, Felix ORCID: 0000-0003-2337-9722, Langhammer, Kristina ORCID: 0000-0002-8104-0308, Enke, Christian, Goepel, Wolfgang, Kribs, Angela ORCID: 0000-0002-0477-5474, Nitzsche, Anika, Riedel, Rainer, Woopen, Christiane ORCID: 0000-0002-7148-6808, Kuntz, Ludwig ORCID: 0000-0002-4083-4574 and Roth, Bernhard (2018). Volume, size, professionals' specialization and nutrition management of NICUs and their association with treatment quality in VLBW infants. J. Perinatol., 38 (4). S. 402 - 411. NEW YORK: NATURE PUBLISHING GROUP. ISSN 1476-5543

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Abstract

Objective To assess the association of volume, size, the availability of highly-specialized professionals and nutrition management of NICUs with treatment quality among VLBW infants. Study design A prospective multicenter study of 923 VLBW infants in 66 German NICUs, born between May and October 2013. Using multilevel modeling, we examined the association between the aforementioned organizational characteristics and treatment quality, measured via major morbidities (severe IVH, PVL, BPD, NEC, FIP, ROP, and discharge without severe complications) and medical process measures of VLBW infants. Results After risk-adjustment and accounting for other NICU characteristics, infants in low-volume NICUs were at higher risk of IVH, ROP and PVL. However, the initial effect of volume on process measures (growth velocity, administration of antenatal steroids) disappeared. Conclusion Volume can only partially explain differences in the treatment quality of VLBWs. The underlying organizational mechanisms should be considered to improve the quality of care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Miedaner, Felix UNSPECIFIED orcid.org/0000-0003-2337-9722 UNSPECIFIED Langhammer, Kristina UNSPECIFIED orcid.org/0000-0002-8104-0308 UNSPECIFIED Enke, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Goepel, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Kribs, Angela UNSPECIFIED orcid.org/0000-0002-0477-5474 UNSPECIFIED Nitzsche, Anika UNSPECIFIED UNSPECIFIED UNSPECIFIED Riedel, Rainer UNSPECIFIED UNSPECIFIED UNSPECIFIED Woopen, Christiane UNSPECIFIED orcid.org/0000-0002-7148-6808 UNSPECIFIED Kuntz, Ludwig UNSPECIFIED orcid.org/0000-0002-4083-4574 UNSPECIFIED Roth, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-190585
DOI:	10.1038/s41372-017-0036-0
Journal or Publication Title:	J. Perinatol.
Volume:	38
Number:	4
Page Range:	S. 402 - 411
Date:	2018
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	NEW YORK
ISSN:	1476-5543
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Sonstiges > Zentrum für Versorgungsforschung Köln
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language LOW-BIRTH-WEIGHT; NEONATAL INTENSIVE-CARE; HOSPITAL VOLUME; PRETERM INFANTS; HUMAN-MILK; MORTALITY; OUTCOMES; LEVEL; PERFORMANCE; HEMORRHAGE Multiple languages Obstetrics & Gynecology; Pediatrics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19058