Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom

J. Profit, J. A. F. Zupancic, M. C. McCormick, D. K. Richardson, G. J. Escobar, Janet Stephen Tucker, W. Tarnow-Mordi, G. Parry

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: To compare gestational age at discharge between infants born at 30-34(+6) weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom.
Design: Prospective observational cohort study.
Setting: Fifty four United Kingdom, five California, and five Massachusetts NICUs.
Subjects: A total of 4359 infants who survived to discharge home after admission to an NICU.
Main outcome measures: Gestational age at discharge home.
Results: The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p = 0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI - 1.2 to 3.0) days earlier in Massachusetts.
Conclusions: Infants of 30-34(+6) weeks gestation at birth admitted and cared for In hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants.

Original languageEnglish
Pages (from-to)F245-F250
Number of pages6
JournalArchives of Disease in Childhood. Fetal and Neonatal Edition
Volume91
DOIs
Publication statusPublished - 2006

Keywords

  • neonatal intensive care
  • managed care
  • NHS
  • mortality
  • index
  • severity
  • outcomes
  • dollar
  • apnea
  • price

Cite this

Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom. / Profit, J.; Zupancic, J. A. F.; McCormick, M. C.; Richardson, D. K.; Escobar, G. J.; Tucker, Janet Stephen; Tarnow-Mordi, W.; Parry, G.

In: Archives of Disease in Childhood. Fetal and Neonatal Edition, Vol. 91, 2006, p. F245-F250 .

Research output: Contribution to journalArticle

Profit, J. ; Zupancic, J. A. F. ; McCormick, M. C. ; Richardson, D. K. ; Escobar, G. J. ; Tucker, Janet Stephen ; Tarnow-Mordi, W. ; Parry, G. / Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom. In: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2006 ; Vol. 91. pp. F245-F250 .
@article{fe0db71ab7a6481bb0d5e4130f0bad2a,
title = "Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom",
abstract = "Objective: To compare gestational age at discharge between infants born at 30-34(+6) weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design: Prospective observational cohort study. Setting: Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects: A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures: Gestational age at discharge home. Results: The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p = 0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95{\%} confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95{\%} CI - 1.2 to 3.0) days earlier in Massachusetts. Conclusions: Infants of 30-34(+6) weeks gestation at birth admitted and cared for In hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants.",
keywords = "neonatal intensive care, managed care, NHS, mortality, index, severity, outcomes, dollar, apnea, price",
author = "J. Profit and Zupancic, {J. A. F.} and McCormick, {M. C.} and Richardson, {D. K.} and Escobar, {G. J.} and Tucker, {Janet Stephen} and W. Tarnow-Mordi and G. Parry",
year = "2006",
doi = "10.1136/adc.2005.075093",
language = "English",
volume = "91",
pages = "F245--F250",
journal = "Archives of Disease in Childhood. Fetal and Neonatal Edition",
issn = "1359-2998",
publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom

AU - Profit, J.

AU - Zupancic, J. A. F.

AU - McCormick, M. C.

AU - Richardson, D. K.

AU - Escobar, G. J.

AU - Tucker, Janet Stephen

AU - Tarnow-Mordi, W.

AU - Parry, G.

PY - 2006

Y1 - 2006

N2 - Objective: To compare gestational age at discharge between infants born at 30-34(+6) weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design: Prospective observational cohort study. Setting: Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects: A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures: Gestational age at discharge home. Results: The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p = 0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI - 1.2 to 3.0) days earlier in Massachusetts. Conclusions: Infants of 30-34(+6) weeks gestation at birth admitted and cared for In hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants.

AB - Objective: To compare gestational age at discharge between infants born at 30-34(+6) weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design: Prospective observational cohort study. Setting: Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects: A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures: Gestational age at discharge home. Results: The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p = 0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI - 1.2 to 3.0) days earlier in Massachusetts. Conclusions: Infants of 30-34(+6) weeks gestation at birth admitted and cared for In hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants.

KW - neonatal intensive care

KW - managed care

KW - NHS

KW - mortality

KW - index

KW - severity

KW - outcomes

KW - dollar

KW - apnea

KW - price

U2 - 10.1136/adc.2005.075093

DO - 10.1136/adc.2005.075093

M3 - Article

VL - 91

SP - F245-F250

JO - Archives of Disease in Childhood. Fetal and Neonatal Edition

JF - Archives of Disease in Childhood. Fetal and Neonatal Edition

SN - 1359-2998

ER -