Quality of care in the delivery hospital contributes to racial disparities in outcomes for low-risk newborns

Abstract

Methods Using 2010–2014 vital statistics and discharge data, Glazer et al identified births at low risk for complications. Various logistic regression models estimated adjusted ORs and calculated standardised rates, accounting for hospital fixed effects, individual (eg, sociodemographic, mother’s health) and hospital (eg, delivery volume, per cent of deliveries publicly insured) characteristics. Outcomes include moderate and severe unexpected newborn complications, using the Joint Commission metric. Hospitals were ranked by outcomes (ratio of expected to observed complications multiplied by overall average rate). The sophisticated analysis assessed sensitivity to choice of outcomes (all, moderate, severe) and considered disparities across all hospitals and within tertiles of quality rank.