{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:58:43Z","timestamp":1790816323886,"version":"4.1.0"},"reference-count":35,"publisher":"American Academy of Pediatrics (AAP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Neonatal care, including intensive care, varies across health care regions. This study measured regional risk-adjusted use of military-insured newborn care and associations with 7-day post-discharge hospital care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS<\/jats:title>\n                    <jats:p>A total of 420\u2009175 live births to military-insured TRICARE beneficiaries, from October 1, 2015 through December 31, 2020, were assigned to regional catchment areas (n\u2009=\u2009103) based on birth location. Administrative records provided sponsor\/parental\/newborn factors associated with neonatal mortality that were used to adjust regional neonatal intensive care unit (NICU) use rates. The associations of these rates and 7-day post-discharge hospital care were estimated with weighted Pearson and Spearman coefficients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Adjusted regional NICU admission rates and numbers of special care days (SCDs) generally varied little for very preterm (VPT) and moderate preterm (MPT) newborns (coefficients of variation [CVs; SD\/mean]&amp;lt;10). Regional variation was high for all types of use in late preterm (LPT) and nonpreterm (NPT) newborns (CVs generally &amp;gt;20). Associations between regional NICU admission and 7-day discharge events were weakly negative for LPT (weighted Pearson correlation coefficient, \u22120.42; 95% CI, \u22120.56 to \u22120.25; R2 0.17) and NPT (\u22120.35; 95% CI, \u22120.49 to \u22120.20; R2 0.12) newborns. Correlation coefficients between NICU admission rates and 7-day post-discharge events for VPT and MPT newborns and for the number of SCDs across all subcohorts were not statistically significant. Similar correlations were observed for 30- and 90-day post-discharge outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Regional variation in NICU use was high for LPT and NPT newborns in both military and civilian hospitals and had weak or unassociated risk of post-hospital care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2025-009012","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:02:57Z","timestamp":1784851377000},"page":"850-860","source":"Crossref","is-referenced-by-count":0,"title":["Variation in Neonatal Intensive Care and Post-Discharge Outcomes in Military-Insured Newborns"],"prefix":"10.1542","volume":"16","author":[{"given":"David C.","family":"Goodman","sequence":"first","affiliation":[{"name":"1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel Medical School at Dartmouth, Hanover, New Hampshire"},{"name":"2Department of Pediatrics, Geisel Medical School at Dartmouth, Hanover, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste J.","family":"Romano","sequence":"additional","affiliation":[{"name":"3Deployment Health Research Department, Naval Health Research Center, San Diego, California"},{"name":"4Leidos, Inc., San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clinton","family":"Hall","sequence":"additional","affiliation":[{"name":"3Deployment Health Research Department, Naval Health Research Center, San Diego, California"},{"name":"4Leidos, Inc., San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoAnna K.","family":"Leyenaar","sequence":"additional","affiliation":[{"name":"1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel Medical School at Dartmouth, Hanover, New Hampshire"},{"name":"2Department of Pediatrics, Geisel Medical School at Dartmouth, Hanover, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gia R.","family":"Gumbs","sequence":"additional","affiliation":[{"name":"3Deployment Health Research Department, Naval Health Research Center, San Diego, California"},{"name":"4Leidos, Inc., San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thornton S.","family":"Mu","sequence":"additional","affiliation":[{"name":"5Pediatrix Medical Group, San Antonio, Texas"},{"name":"6Department of Pediatrics, CHRISTUS Children\u2019s Hospital\/Baylor College of Medicine, San Antonio, Texas"},{"name":"7Department of Graduate Medical Education, Brooke Army Medical Center, Fort Sam Houston, Texas"},{"name":"8Department of Pediatrics, USU School of Medicine, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava Marie S.","family":"Conlin","sequence":"additional","affiliation":[{"name":"3Deployment Health Research 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