Author | Wehby, George L. | |
Author | Lopez-Camelo, Jorge | |
Author | Castilla, Eduardo E. | |
Access date | 2016-08-17T17:15:30Z | |
Available date | 2016-08-17T17:15:30Z | |
Document date | 2012 | |
Citation | WEHBY, George L.; LOPEZ-CAMELO, Jorge; CASTILLA, Eduardo E. Hospital Volume and Mortality of Very Low-Birthweight Infants in South America. Health Services Research, v.47, n.4, p.1502-1521, Aug. 2012. | pt_BR |
ISSN | 1475-6773 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/15296 | |
Language | eng | pt_BR |
Publisher | Wiley Online Library | pt_BR |
Rights | open access | |
Subject in Portuguese | Saúde infantil | pt_BR |
Subject in Portuguese | Saúde do Adolescente | pt_BR |
Subject in Portuguese | Hospitais | pt_BR |
Subject in Portuguese | Pediatria | pt_BR |
Subject in Portuguese | Cuidados maternos e peerinatal | pt_BR |
Subject in Portuguese | Qualidade do cuidado | pt_BR |
Subject in Portuguese | Redes de referência | pt_BR |
Subject in Portuguese | Segurança do paciente | pt_BR |
Subject in Portuguese | Baixo peso de nascimento | pt_BR |
Subject in Portuguese | América do Sul | pt_BR |
Title | Hospital volume and mortality of very low-birthweight infants in South America | pt_BR |
Type | Article | |
DOI | 10.1111/j.1475-6773.2012.01383.x | |
Abstract | Objective. To assess the effects of hospital volume of very low-birthweight (VLBW)
infants on in-hospital mortality of VLBW and very preterm birth (VPB) infants in
South America.
Data Sources/Study Setting. Birth-registry data for infants born in 1982–2008 at
VLBWor very preterm in 66 hospitals in Argentina, Brazil, and Chile.
Design. Regression analyses that adjust for several individual-level demographic,
socioeconomic, and health factors; hospital-level characteristics; and country-fixed
effects are employed.
Data Collection/Extraction Methods. Physicians interviewed mothers before hospital
discharge and abstracted hospital medical records using similar methods at all
hospitals.
Principal Findings. Volume has significant nonlinear beneficial effects on VLBW
and VPB in-hospital survival. The largest survival benefits––more than 80 percent
decrease in mortality rates––are with volume increases from low to medium or medium-high
levels (from 25 to 72 infants annually) with significantly lower incremental
benefits thereafter. The cumulative volume effects are maximized at the 121–144
annual VLBW infant range––about 90 percent decrease in mortality rates compared to
<25 VLBW infants annually.
Conclusions. Increasing the access of pregnancies at-risk of VLBW and VPB to medium-
or high-volume hospitals up to 144 VLBW infants per year may substantially
improve in-hospital infant survival in the study countries. | pt_BR |
Affilliation | University of Iowa. College of Public Health. Department of Health Management and Policy. Iowa City, IA, USA. | pt_BR |
Affilliation | Centro de Educación Médica e Investigaciones Clínicas (CEMIC). Buenos Aires. Argentina / ECLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas). Imbice, La Plata, Argentina. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia de Malformações Congênitas. INAGEMP (Instituto Nacional de Genética Médica Populacional) and ECLAMC. Rio de Janeiro, RJ, Brasil. | pt_BR |
Subject | Child and adolescent health | pt_BR |
Subject | Hospitals | pt_BR |
Subject | Maternal and perinatal care and outcomes | pt_BR |
Subject | Referrals and referral networks | pt_BR |
Subject | Quality of care/patient safety (measurement) | pt_BR |
Subject | Pediatrics | pt_BR |
Subject | Low-birthweight | pt_BR |
Subject | South America | pt_BR |