Hanadi Y Hamadi1, Jing Xu2, Aurora A Tafili3, Farouk S Smith2, Aaron C Spaulding4. 1. Health Administration Program, Department of Health Administration, University of North Florida, 1 UNF Drive, Building 39 Room 4033, Jacksonville, FL, 32224, USA. h.hamadi@unf.edu. 2. Health Administration Program, Department of Health Administration, University of North Florida, 1 UNF Drive, Building 39 Room 4033, Jacksonville, FL, 32224, USA. 3. Department of Health Services Administration, University of Alabama at Birmingham, 1720 University Blvd, Birmingham, AL, 35294, USA. 4. Division of Health Care Policy and Research, Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 4500 San Pablo Drive, Jacksonville, FL, 32224, USA.
Abstract
INTRODUCTION: Birth trauma rates in term of neonates is a quality measure used by the Joint Commission. In the United States birth trauma rates occurs at a rate of 37 per 1000 live births and are on the decline. However, this decline has been significantly lower among term neonates born in rural facilities. There is a critical lack of evidence toward the influence geographical risk factors has on birth trauma rates for neonatal patients. We sought to measure rural community and hospital characteristics associated with birth trauma. METHODS: A retrospective longitudinal study design was used to examine inpatient medical discharge data across 103 hospitals of neonates at birth from 2013 to 2018. Discharge data was linked to the American Hospital Association annual survey. We used a multi-level mixed effect model to investigate the relationship between individual and hospital-level attributes associated with increased risk of birth trauma among neonatal patients. RESULTS: We found that rural hospitals were 3.99 times (p < 0.001) more likely to experience higher birth trauma than urban hospitals. Medium sized hospitals were 2.11 times (p < 0.001) more likely to experience higher birth trauma. Hospitals who indicate having a safety culture were more likely (p < 0.05) to have high rates of birth trauma. DISCUSSION: Neonates born at rural hospitals, were more likely to experience a birth-related injury. Policy strategies focusing on improving health care quality in rural areas are critical to mitigating this increased risk of birth trauma. Further research is required to assess how physician characteristics may impact birth trauma rates.
INTRODUCTION: Birth trauma rates in term of neonates is a quality measure used by the Joint Commission. In the United States birth trauma rates occurs at a rate of 37 per 1000 live births and are on the decline. However, this decline has been significantly lower among term neonates born in rural facilities. There is a critical lack of evidence toward the influence geographical risk factors has on birth trauma rates for neonatal patients. We sought to measure rural community and hospital characteristics associated with birth trauma. METHODS: A retrospective longitudinal study design was used to examine inpatient medical discharge data across 103 hospitals of neonates at birth from 2013 to 2018. Discharge data was linked to the American Hospital Association annual survey. We used a multi-level mixed effect model to investigate the relationship between individual and hospital-level attributes associated with increased risk of birth trauma among neonatal patients. RESULTS: We found that rural hospitals were 3.99 times (p < 0.001) more likely to experience higher birth trauma than urban hospitals. Medium sized hospitals were 2.11 times (p < 0.001) more likely to experience higher birth trauma. Hospitals who indicate having a safety culture were more likely (p < 0.05) to have high rates of birth trauma. DISCUSSION: Neonates born at rural hospitals, were more likely to experience a birth-related injury. Policy strategies focusing on improving health care quality in rural areas are critical to mitigating this increased risk of birth trauma. Further research is required to assess how physician characteristics may impact birth trauma rates.
Authors: William A Grobman; Jennifer L Bailit; Madeline Murguia Rice; Ronald J Wapner; Uma M Reddy; Michael W Varner; John M Thorp; Kenneth J Leveno; Steve N Caritis; Jay D Iams; Alan T N Tita; George Saade; Dwight J Rouse; Sean C Blackwell; Jorge E Tolosa; J Peter VanDorsten Journal: Obstet Gynecol Date: 2015-06 Impact factor: 7.661
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Authors: Utkarsh Kohli; Lavina Desai; Devyani Chowdhury; Ashraf S Harahsheh; Alexandra B Yonts; Annette Ansong; Arash Sabati; Hoang H Nguyen; Tarique Hussain; Danyal Khan; David A Parra; Jennifer A Su; Jyoti K Patel; Christina Ronai; Monique Bohun; Bishara J Freij; Matthew J O'Connor; Joseph W Rosanno; Aamisha Gupta; Arash Salavitabar; Adam L Dorfman; Jesse Hansen; Olivia Frosch; Elizabeth L Profita; Shiraz Maskatia; Deepika Thacker; Shubhika Shrivastava; Tyler H Harris; Brian Feingold; Stuart Berger; Michael Campbell; Salim F Idriss; Srikant Das; Markus S Renno; Ken Knecht; S Yukiko Asaki; Sunil Patel; Ravi Ashwath; Renata Shih; John Phillips; Bibhuti Das; Preeti Ramachandran; Eyal Sagiv; Aarti H Bhat; Jonathan N Johnson; Nathaniel W Taggart; Jason Imundo; Natasha Nakra; Shashank Behere; Anjlee Patel; Avichal Aggarwal; Saif Aljemmali; Sean Lang; Sarosh P Batlivala; Daniel E Forsha; Gregory P Conners; Jana Shaw; Frank C Smith; Linda Pauliks; Joseph Vettukattil; Kenneth Shaffer; Stefanie Cheang; Sonia Voleti; Rajesh Shenoy; Rukmini Komarlu; Shea J Ryan; Christopher Snyder; Neha Bansal; Madhu Sharma; Jeffrey A Robinson; Sandra R Arnold; Christine M Salvatore; Madan Kumar; Michael A Fremed; Julie S Glickstein; Melissa Perrotta; William Orr; Tamika Rozema; Muthayipalayam Thirumoorthi; Charles J Mullett; Jocelyn Y Ang Journal: J Pediatr Date: 2021-12-22 Impact factor: 4.406