TY  - JOUR
T1  - COrrelation of neonatal intensive care unit performance across multiple measures of quality of care
AU  - Profit J, Zupancic JF, Gould JB, et al
Y1  - 2013/01/01
N1  - 10.1001/jamapediatrics.2013.418
JO  - JAMA Pediatrics
SP  - 47
EP  - 54
VL  - 167
IS  - 1
N2  - Objectives 
                  To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance.Design 
                  We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations.Setting 
                  Twenty-two regional NICUs in California.Patients 
                  In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007.Main Outcomes Measures 
                  Pneumothorax, growth velocity, health care–associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk.Results 
                  The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations, 6 were significant (ρ < .05). Correlations between pairs of measures of quality of care were strong (ρ ≥ .5) for 1 pair, moderate (range, ρ ≥ .3 to ρ < .5) for 8 pairs, weak (range, ρ ≥ .1 to ρ < .3) for 5 pairs, and negligible (ρ < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care–associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4.Conclusion 
                  In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest.
SN  - 2168-6203
M3  - doi: 10.1001/jamapediatrics.2013.418
UR  - http://dx.doi.org/10.1001/jamapediatrics.2013.418
ER  -