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dc.contributor.author
Wehby, George
dc.contributor.author
López Camelo, Jorge Santiago
dc.contributor.author
Castilla, Eduardo Enrique
dc.date.available
2020-01-21T20:49:26Z
dc.date.issued
2012-08
dc.identifier.citation
Wehby, George; López Camelo, Jorge Santiago; Castilla, Eduardo Enrique; Hospital Volume and Mortality of Very Low-Birthweight Infants in South America; Wiley Blackwell Publishing, Inc; Health Services Research; 47; 4; 8-2012; 1502-1521
dc.identifier.issn
0017-9124
dc.identifier.uri
http://hdl.handle.net/11336/95486
dc.description.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 VLBW or 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.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Wiley Blackwell Publishing, Inc
dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.subject
CHILD AND ADOLESCENT HEALTH
dc.subject
HOSPITALS
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MATERNAL AND PERINATAL CARE AND OUTCOMES
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PEDIATRICS
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QUALITY OF CARE/PATIENT SAFETY (MEASUREMENT)
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REFERRALS AND REFERRAL NETWORKS
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Epidemiología
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Ciencias de la Salud
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CIENCIAS MÉDICAS Y DE LA SALUD
dc.title
Hospital Volume and Mortality of Very Low-Birthweight Infants in South America
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2019-09-24T17:36:18Z
dc.journal.volume
47
dc.journal.number
4
dc.journal.pagination
1502-1521
dc.journal.pais
Reino Unido
dc.journal.ciudad
Londres
dc.description.fil
Fil: Wehby, George. University of Iowa; Estados Unidos
dc.description.fil
Fil: López Camelo, Jorge Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
dc.description.fil
Fil: Castilla, Eduardo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán". Centro Nacional de Genética Médica; Argentina. Fundación Oswaldo Cruz; Brasil
dc.journal.title
Health Services Research
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2012.01383.x
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