Abstract
ObjectiveOur objective was to incorporate social and built environment factors into a compendium of multilevel factors among a cohort of very low birth weight infants to understand their contributions to inequities in NICU quality of care and support providers and NICUs in addressing these inequities via development of a health equity dashboard.Study designWe examined bivariate associations between NICU patient pool and NICU catchment area characteristics and NICU quality of care with data from a cohort of 15,901 infants from 119 NICUs in California, born 2008–2011.ResultNICUs with higher proportion of minority racial/ethnic patients and lower SES patients had lower quality scores. NICUs with catchment areas of lower SES, higher composition of minority residents, and more household crowding had lower quality scores.ConclusionMultilevel social factors impact quality of care in the NICU. Their incorporation into a health equity dashboard can inform providers of their patients’ potential resource needs.
Highlights
Persistent racial/ethnic inequities in adverse birth outcomes are the focus of many reports, though little progress has been made to improve equity in care and outcomes
Inequities often increase with severity of outcomes; for example, Black infants are at twofold risk of low birth weight (
Researchers have focused on the role of social determinants on health outcomes, recently, researchers have highlighted that neonatal intensive care unit (NICU) quality of care delivery may compound or reduce disparities by identifying those at higher risk [3]
Summary
Persistent racial/ethnic inequities in adverse birth outcomes are the focus of many reports, though little progress has been made to improve equity in care and outcomes. Inequities often increase with severity of outcomes; for example, Black infants are at twofold risk of low birth weight (
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