Associations Between Hospital Maternal Service Level and Delivery Outcomes
| Autor: | Susan E. Shapiro, Anne L. Dunlop, Bryan L. Williams, Roger W. Rochat, Jennifer Vanderlaan |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Georgia Health (social science) Hospitals Maternity Logistic regression Odds 03 medical and health sciences 0302 clinical medicine Pregnancy Infant Mortality Maternity and Midwifery Odds Ratio Humans Medicine 030212 general & internal medicine Survival analysis Quality of Health Care 030219 obstetrics & reproductive medicine Framingham Risk Score business.industry Obstetrics Infant Newborn Public Health Environmental and Occupational Health Infant Obstetrics and Gynecology Odds ratio Infant Low Birth Weight Delivery Obstetric medicine.disease Survival Analysis Infant mortality Low birth weight Premature Birth Female medicine.symptom business |
| Zdroj: | Women's Health Issues. 29:252-258 |
| ISSN: | 1049-3867 |
| DOI: | 10.1016/j.whi.2019.02.004 |
| Popis: | Objective This study explored the associations between delivery hospital self-reported level of maternal service, as defined by the American Hospital Association, and both maternal and neonatal outcomes among women at high maternal risk, as defined by the Obstetric Comorbidity Index. Methods This was a secondary analysis of linked delivery hospitalization discharge and vital records data for women experiencing singleton births in Georgia from 2008 to 2012. The need for maternal transfer was defined using a sample-specific cut-off of the risk score calculated using the Obstetric Comorbidity Index. Outcomes included poor maternal outcome (severe maternal morbidity or death), maternal length of stay, preterm delivery, low birth weight, and perinatal death. The analysis was completed using hierarchical logistic regression with a two-level model considering hospital level of maternal service and controlling for maternal race and transfer status. Results In these data, there was no difference in the odds of a poor maternal or neonatal outcome according to delivery hospital level of maternal care; however, delivery at a hospital with maternal service level III was associated with a higher odds of an extended length of stay. Conclusions For this group of pregnant women in need of maternal transfer, delivery hospital self-reported level of maternal care was not associated with the odds of poor maternal or neonatal outcomes. This study supports the need for improved definitions of hospital level of maternal services. |
| Databáze: | OpenAIRE |
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