Improving perinatal regionalization: 10 years of experience with an Arkansas initiative

Objective To examine the impact of Antenatal and Neonatal Guidelines, Education and Learning Systems (ANGELS) on neonatal intensive care unit (NICU) preterm delivery rates. Study design In this longitudinal observational study, linked vital records and Medicaid claims records for 29,124 preterm birt...

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Bibliographic Details
Published in:Journal of perinatology 2020-11, Vol.40 (11), p.1609-1616
Main Authors: Bronstein, Janet M., Ounpraseuth, Songthip, Lowery, Curtis L.
Format: Article
Language:English
Subjects:
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692/700/228
Arkansas
Female
Government programs
Humans
Infant, Newborn
Infants (Premature)
Intensive care
Intensive Care Units, Neonatal
Medicaid
Medicine
Medicine & Public Health
Neonatal care
Neonatal intensive care
Neonates
Neonatology
Neonatology - standards
Pediatric Surgery
Pediatrics
Pregnancy
Pregnant women
Premature Birth
Prenatal Care
Statistical analysis
Travel time
Type 2 diabetes
United States
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Summary:Objective To examine the impact of Antenatal and Neonatal Guidelines, Education and Learning Systems (ANGELS) on neonatal intensive care unit (NICU) preterm delivery rates. Study design In this longitudinal observational study, linked vital records and Medicaid claims records for 29,124 preterm births (April 2001–December 2012) to Medicaid covered women were used to examine factors predicting whether deliveries occurred at hospitals with neonatology-staffed NICUs. The factors associated with delivery are estimated and compared for baseline and three post-implementation periods. Results Rates for NICU preterm deliveries increased from 28 to 37% over the time period. Compared to baseline, adjusted NICU delivery rates in the middle and late implementation periods were statistically significant ( p  
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-020-0726-x