TY - JOUR
T1 - Mortality among very low-birthweight infants in hospitals serving minority populations
AU - Morales, Leo S.
AU - Staiger, Douglas
AU - Horbar, Jeffrey D.
AU - Carpenter, Joseph
AU - Kenny, Michael
AU - Geppert, Jeffrey
AU - Rogowski, Jeannette
PY - 2005/12
Y1 - 2005/12
N2 - Objective. We investigated whether the proportion of Black very low-birthweight (VLBW) infants treated by hospitals is associated with neonatal mortality for Black and White VLBW infants. Methods. We analyzed medical records linked to secondary data sources for 74050 Black and White VLBW infants (501 g to 1500 g) treated by 332 hospitals participating in the Vermont Oxford Network from 1995 to 2000. Hospitals where more than 35% of VLBW infants treated were Black were defined as "minority-serving." Results. Compared with hospitals where less than 15% of the VLBW infants were Black, minority-serving hospitals had significantly higher risk-adjusted neonatal mortality rates (White infants: odds ratio [OR] = 1.30, 95% confidence interval [CI]= 1.09, 1.56; Black infants: OR = 1.29, 95% CI= 1.01, 1.64; Pooled: OR = 1.28, 95% CI = 1.10, 1.50). Higher neonatal mortality in minority-serving hospitals was not explained by either hospital or treatment variables. Conclusions. Minority-serving hospitals may provide lower quality of care to VLBW infants compared with other hospitals. Because VLBW Black infants are disproportionately treated by minority-serving hospitals, higher neonatal mortality rates at these hospitals may contribute to racial disparities in infant mortality in the United States.
AB - Objective. We investigated whether the proportion of Black very low-birthweight (VLBW) infants treated by hospitals is associated with neonatal mortality for Black and White VLBW infants. Methods. We analyzed medical records linked to secondary data sources for 74050 Black and White VLBW infants (501 g to 1500 g) treated by 332 hospitals participating in the Vermont Oxford Network from 1995 to 2000. Hospitals where more than 35% of VLBW infants treated were Black were defined as "minority-serving." Results. Compared with hospitals where less than 15% of the VLBW infants were Black, minority-serving hospitals had significantly higher risk-adjusted neonatal mortality rates (White infants: odds ratio [OR] = 1.30, 95% confidence interval [CI]= 1.09, 1.56; Black infants: OR = 1.29, 95% CI= 1.01, 1.64; Pooled: OR = 1.28, 95% CI = 1.10, 1.50). Higher neonatal mortality in minority-serving hospitals was not explained by either hospital or treatment variables. Conclusions. Minority-serving hospitals may provide lower quality of care to VLBW infants compared with other hospitals. Because VLBW Black infants are disproportionately treated by minority-serving hospitals, higher neonatal mortality rates at these hospitals may contribute to racial disparities in infant mortality in the United States.
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U2 - 10.2105/AJPH.2004.046730
DO - 10.2105/AJPH.2004.046730
M3 - Article
C2 - 16304133
AN - SCOPUS:28444470169
SN - 0090-0036
VL - 95
SP - 2206
EP - 2212
JO - American journal of public health
JF - American journal of public health
IS - 12
ER -