Disparities in Perinatal Quality Outcomes for Very Low Birth Weight Infants in Neonatal Intensive Care

Objective

To determine if hospital‐level disparities in very low birth weight () infant outcomes are explained by poorer hospital nursing characteristics.

Data Sources

Nurse survey and infant registry data.

Study Design

Retrospective study of 8,252 infants in 98 Vermont Oxford Network hospital neonatal intensive care units (s) nationally. s were classified into three groups based on their percent of infants of black race. Two nurse‐sensitive perinatal quality standards were studied: nosocomial infection and breast milk.

Data Collection

Primary nurse survey ( = 5,773, 77 percent response rate).

Principal Findings

infants born in high‐black concentration hospitals had higher rates of infection and discharge without breast milk than infants born in low‐black concentration hospitals. Nurse understaffing was higher and practice environments were worse in high‐black as compared to low‐black hospitals. nursing features accounted for one‐third to one‐half of the hospital‐level health disparities.

Conclusions

Poorer nursing characteristics contribute to disparities in infant outcomes in two nurse‐sensitive perinatal quality standards. Improvements in nursing have potential to improve the quality of care for seven out of ten black infants who are born in high‐black hospitals in this country.