{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:04:49Z","timestamp":1790946289076,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T00:00:00Z","timestamp":1537747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS023801"],"award-info":[{"award-number":["R01HS023801"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aims to examine hospital variation in both maternal and neonatal morbidities and identify institutional characteristics associated with hospital performance in a combined measure of maternal and neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the California Linked Birth File containing data from birth certificate and hospital discharge records, we identified 1\u00a0322\u00a0713 term births delivered at 248 hospitals during 2010\u20102012. For each hospital, a risk\u2010standardized rate of severe maternal morbidities and a risk\u2010standardized rate of severe newborn morbidities were calculated after adjusting for patient clinical risk factors. Hospitals were ranked based on combined information on their maternal and newborn morbidity rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Risk\u2010standardized severe maternal and severe newborn morbidity rates varied substantially across hospitals (10th to 90th percentile range\u00a0=\u00a067.5\u2010148.2 and 141.8\u2010508.0 per 10\u00a0000 term births, respectively), although there was no significant association between the two (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.15). Government hospitals (non\u2010Federal) were more likely than other hospitals to be in worse rank quartiles (<jats:italic>P<\/jats:italic> value for trend\u00a0=\u00a00.004), whereas larger volume was associated with better rank among hospitals in the first three quartiles (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.004). The most prevalent morbidities that differed progressively across hospital rank quartiles were severe hemorrhage, disseminated intravascular coagulation, and heart failure during procedure\/surgery for mothers, and severe infection, respiratory complication, and shock\/resuscitation for neonates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hospitals with low maternal morbidity rates may not have low neonatal morbidity rates and vice versa, highlighting the importance of assessing joint maternal\u2010newborn outcomes in order to fully characterize a hospital's obstetrical performance. Hospitals with smaller volume and government ownership tend to have less desirable outcomes and warrant additional attention in future quality improvement efforts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12400","type":"journal-article","created":{"date-parts":[[2018,9,25]],"date-time":"2018-09-25T01:59:53Z","timestamp":1537840793000},"page":"289-299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Optimal maternal and neonatal outcomes and associated hospital characteristics"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3013-7169","authenticated-orcid":false,"given":"Katherine H.","family":"Campbell","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine  New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Illuzzi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine  New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neonatal &amp; Developmental Medicine Stanford University School of Medicine Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiqun","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Yale School of Public Health New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather S.","family":"Lipkind","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine  New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisbet S.","family":"Lundsberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine  New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian M.","family":"Pettker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine  New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine  New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,24]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Healthy Mom, Healthy Baby (A March of Dimes Book): The Ultimate Pregnancy Guide","author":"Dolan S","year":"2013"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.03.011"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.514629"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.13381"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.05.007"},{"key":"e_1_2_6_7_1","unstructured":"The Joint Commission.Perinatal core measures. Joint Commission website 2017.https:\/\/www.jointcommission.org\/perinatal_care\/. Accessed May 15 2017."},{"key":"e_1_2_6_8_1","unstructured":"Centers for Disease Control and Prevention.Rates in severe morbidity indicators per 10 000 delivery hospitalizations 1993\u20132014.https:\/\/www.cdc.gov\/reproductivehealth\/maternalinfanthealth\/smm\/rates-severe-morbidity-indicator.htm. Accessed June 15 2018."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-25"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7475.1177"},{"key":"e_1_2_6_11_1","unstructured":"Office of Statewide Health Planning and Development (OSHPD).State of California.https:\/\/www.oshpd.ca.gov\/HID\/Data_Request_Center\/Types_of_Data.html. Accessed October 11 2016."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1006\/cbmr.1997.1448"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12149"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2012.1030"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.1088"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.07.019"},{"key":"e_1_2_6_17_1","unstructured":"American Hospital Association.AHA annual survey database.https:\/\/www.ahadataviewer.com\/book-cd-products\/AHA-Survey\/. Accessed October 11 2016."},{"key":"e_1_2_6_18_1","unstructured":"California Perinatal Quality Care Collaborative (CPQCC).https:\/\/www.cpqcc.org\/. Accessed April 28 2017."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1999"},{"key":"e_1_2_6_20_1","unstructured":"Office of Statewide Health Planning and Development (OSHPD).State of California. Hospital annual financial data.https:\/\/www.oshpd.ca.gov\/HID\/Hospital-Financial.asp. Accessed September 29 2017."},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31826d60c5"},{"key":"e_1_2_6_22_1","unstructured":"Centers for Disease Control and Prevention.Severe maternal morbidity in the United States.https:\/\/www.cdc.gov\/reproductivehealth\/MaternalInfantHealth\/SevereMaternalMorbidity.html. Accessed May 15 2017."},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.710280"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.11.004"},{"key":"e_1_2_6_25_1","unstructured":"California Maternal Quality Care Collaborative.Unexpected complications in term newborns.https:\/\/www.cmqcc.org\/focus-areas\/quality-metrics\/unexpected-complications-term-newborns. Accessed March 16 2016."},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15007"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.3566"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281675"},{"key":"e_1_2_6_29_1","unstructured":"AshA FienbergS LouisT NormandS StukelT UttsJ.Statistical issues in assessing hospital performance.2012.https:\/\/www.cms.gov\/Medicare\/Quality-Initiatives-Patient-Assessment-Instruments\/HospitalQualityInits\/Downloads\/Statistical-Issues-in-Assessing-Hospital-Performance.pdf. Accessed June 29 2017."},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12165"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.01.017"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1333"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-005-0006-6"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2013.1359"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181d74898"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.09.026"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.09.029"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000322"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000328"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.02.096"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbirt.12400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.12400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/birt.12400","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.12400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T18:46:36Z","timestamp":1694371596000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.12400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,24]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1111\/birt.12400"],"URL":"https:\/\/doi.org\/10.1111\/birt.12400","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,24]]},"assertion":[{"value":"2018-03-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}