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UNT Variation and Disparities in the NICU Questions

Variation and Disparities in the NICU

Medical researchers in California (Profit et al., 2017) examined differences in NICU quality of care provided to very low birthweight (<1500 g) infants to illuminate the persistent problem of racial and/or ethnic disparities. Their prospective observational analysis included more than 18,000 very low birthweight infants in 134 NICUs in California between 2010 and 2014. Using a composite indicator called the Baby-MONITOR, they calculated quality scores for each race and/or ethnicity and compared quality of care between and within NICUs.

According to an online report about this study (Digitale, 2017), “The disparities were not uniform: At some California hospitals, infants from vulnerable populations received worse care than white infants, while at others, they received better care than whites. In general, however, the hospitals with the best outcomes for their patients also delivered better care to white infants. In addition, the study found that black and Hispanic infants were more likely than white infants to receive care in poor-quality NICUs.”

The study also showed that:

  • “Across the state, white infants scored higher on measures of whether standard medical practices were being followed.”
  • “Black infants had lower rates than white infants of receiving any human milk at discharge — an indicator of worse outcomes — but also had better outcomes in some areas, including faster growth rates and lower rates of chronic lung disease and collapsed lung.”
  • “Hispanic infants did worse than whites on all components of the score except collapsed-lung rates.”

By documenting variation in quality of care in the NICU, the researchers hope to increase awareness and ultimately reduce racial/ethnic disparities.

Answer the following questions. Full credit will be given to students who thoughtfully answer all 4 questions You can read more about the studies, by following the links in the references, but it is not required.

  1. How might a very low birthweight infant’s race and/or ethnicity influence the care that he or she receives in the NICU?
  2. What other characteristics of infants, parents, or NICU staff might be relevant to consider? How might factors, such as socioeconomic, linguistic, or biological differences, influence NICU outcomes?
  3. How could these findings be used to educate health care providers in the NICU? How could they be used with parents of very low birthweight infants?
  4. What are the potential limitations of this study’s focus on NICUs in California? What are some potential benefits of selecting California to carry out this research?

Digitale, E. (August 27, 2017). Infants’ race influences quality of hospital care in California.https://med.stanford.edu/news/all-news/2017/08/inf…

Profit, J., Gould, J.B., Bennett, M., Goldstein, B.A., Draper, D., Phibbs, C.S., et al. (2017). Racial/ethnic disparity in NICU quality of care delivery. Pediatrics, 140(3), e20170918. DOI: https://doi.org/10.1542/peds.2017-0918

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