Multilevel social factors and NICU quality of care in California

Objective: To incorporate social and built environment factors into a compendium of multilevel factors among a cohort of very low birth weight infants to understand their contributions to inequities in NICU quality of care and support providers and NICUs in addressing these inequities via development of a health equity dashboard. Study design: We examined bivariate associations between NICU patient pool and NICU catchment area characteristics and NICU quality of care with data from a cohort of 15,901 infants from 119 NICUs in California, born 2008–2011. Result: NICUs with higher proportion of minority racial/ethnic patients and lower SES patients had lower quality scores. NICUs with catchment areas of lower SES, higher composition of minority residents, and more household crowding had lower quality scores. Conclusion: Multilevel social factors impact quality of care in the NICU. Their incorporation into a health equity dashboard can inform providers of their patients’ potential resource needs.

Amy M. Padula, Salma Shariff-Marco, Juan Yang, Jennifer Jain, Jessica Liu, Shannon M. Conroy, Suzan L. Carmichael, Scarlett L. Gomez, Ciaran Phibbs, John Oehlert, Jeffrey B. Gould, Jochen Profit