{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:25:20Z","timestamp":1790101520897,"version":"4.0.1"},"reference-count":47,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Because greater percentages of women deliver at hospitals without high-level NICUs, there is little information on the effect of delivery hospital on the outcomes of premature infants in the past 2 decades, or how these effects differ across states with different perinatal regionalization systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A retrospective population-based cohort study was constructed of all hospital-based deliveries in Pennsylvania and California between 1995 and 2005 and Missouri between 1995 and 2003 with a gestational age between 23 and 37 weeks (N = 1\u2009328\u2009132). The effect of delivery at a high-level NICU on in-hospital death and 5 complications of premature birth was calculated by using an instrumental variables approach to control for measured and unmeasured differences between hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Infants who were delivered at a high-level NICU had significantly fewer in-hospital deaths in Pennsylvania (7.8 fewer deaths\/1000 deliveries, 95% confidence interval [CI] 4.1\u201311.5), California (2.7 fewer deaths\/1000 deliveries, 95% CI 0.9\u20134.5), and Missouri (12.6 fewer deaths\/1000 deliveries, 95% CI 2.6\u201322.6). Deliveries at high-level NICUs had similar rates of most complications, with the exception of lower bronchopulmonary dysplasia rates at Missouri high-level NICUs (9.5 fewer cases\/1000 deliveries, 95% CI 0.7\u201318.4) and higher infection rates at high-level NICUs in Pennsylvania and California. The association between delivery hospital, in-hospital mortality, and complications differed across the 3 states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>There is benefit to neonatal outcomes when high-risk infants are delivered at high-level NICUs that is larger than previously reported, although the effects differ between states, which may be attributable to different methods of regionalization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2011-2820","type":"journal-article","created":{"date-parts":[[2012,7,10]],"date-time":"2012-07-10T10:17:09Z","timestamp":1341915429000},"page":"270-278","source":"Crossref","is-referenced-by-count":187,"title":["The Differential Impact of Delivery Hospital on the Outcomes of Premature Infants"],"prefix":"10.1542","volume":"130","author":[{"given":"Scott A.","family":"Lorch","sequence":"first","affiliation":[{"name":"Department of Pediatrics, The Children\u2019s Hospital of Philadelphia and The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;"},{"name":"Center for Outcomes Research, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"},{"name":"Senior Fellow, Leonard Davis Institute of Health Economics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Baiocchi","sequence":"additional","affiliation":[{"name":"Department of Statistics, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania; and"},{"name":"Department of Statistics, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne E.","family":"Ahlberg","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan S.","family":"Small","sequence":"additional","affiliation":[{"name":"Senior Fellow, Leonard Davis Institute of Health Economics, and"},{"name":"Department of Statistics, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,8,1]]},"reference":[{"key":"2021120821032525400_B1","volume-title":"Emergency Medical Services at the Crossroads. 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