Improving Quality of Care Can Mitigate Persistent Disparities.

Abstract

* Abbreviation: QI — : quality improvement Outcomes for preterm infants treated in NICUs have improved in the last 25 years but progress has been unequal.1 Persistent racial and ethnic disparities exist in this vulnerable population.2 Although disparities are rooted in a complex set of causes, there is increasing recognition that differential quality of care is a contributing factor.3–5 Minority infants are more likely to receive care at poor-quality NICUs5,6 and more likely to receive worse care than white infants within a NICU.3 African American and Hispanic infants are at particular risk. Eliminating deficits in the quality of care for minority infants requires a granular understanding of differences in care across different racial and ethnic groups. In this issue of Pediatrics , Boghossian et al7 evaluate racial and ethnic differences over time in care practices for 215 000 infants born at 22 through 29 weeks’ gestation between January 2006 and December 2017 at US centers of the Vermont Oxford Network, a voluntary network of NICUs focused on quality improvement (QI). This study has several strengths: a national data set drawn from 789 NICUs representing 88% of all US births … Address correspondence to Dhurjati Ravi, MS, PhD, Division of Neonatology and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Medical School Office Building, 1265 Welch Rd, Stanford, CA 94305. E-mail: dhurjati{at}stanford.edu