Objectives: To develop quality of care (QoC) indicators, evaluate the quality of the processes of care (QPC) and clinical outcomes, and analyze the association between the QPC and severe clinical outcomes of preterm newborns admitted to neonatal intensive care units (NICUs).
Design: Mixed methods approach: (1) development of QoC indicators via modified RAND/UCLA method; (2) cross-sectional study of QoC evaluation and (3) multiple logistic regression analysis to ascertain the association between the QPC and severe clinical outcomes.
Setting: Two NICUs belonged to the Mexican Institute of Social Security in Mexico City.
Participants: About 489 preterm neonates (<37 weeks of gestation) without severe congenital anomalies.
Main Outcome Measure(s): The QoC indicators; ≥60% of recommended QPC and severe clinical outcomes.
Results: The QoC included 10 QPC indicators across four domains: respiratory, nutrition and metabolism, infectious diseases, and screening, and five outcome indicators. The lower QPC indicators were for the nutrition and metabolism domain (17.8% started enteral feeding with human milk, and 20.7% received sodium bicarbonate appropriately). The higher QPC indicator was for the screening domain (97.6% of neonates <30 weeks gestation underwent early (≤14 days) transfontanelar ultrasound). The mean recommended QPC that neonates received was 47.5%. Only 26.6% of neonates received ≥60% of recommended QPC. About 60.7% of neonates developed severe clinical outcomes including mortality and healthcare-related major morbidity. Receiving ≥60% of recommended QPC was associated with a decrease of nearly half of odds of severe clinical outcomes.
Conclusion: The evaluation of the QoC in NICUs is essential to address modifiable gaps in quality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/intqhc/mzy061 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
An Acetylcholine M1 Receptor-Positive Allosteric Modulator (TAK-071) in Parkinson Disease With Cognitive Impairment: A Phase 2 Randomized Clinical Trial.
JAMA Neurol
January 2025
Takeda Development Center Americas, Inc, Cambridge, Massachusetts.
Importance: Fall risk and cognitive impairment are prevalent and burdensome in Parkinson disease (PD), requiring efficacious, well-tolerated treatment.
Objective: To evaluate the safety and efficacy of TAK-071, a muscarinic acetylcholine M1 positive allosteric modulator, in participants with PD, increased fall risk, and cognitive impairment.
Design, Setting, And Participants: This phase 2 randomized double-blind placebo-controlled crossover clinical trial was conducted from October 21, 2020, to February 27, 2023, at 19 sites in the US.
Doxycycline Postexposure Prophylaxis and Bacterial Sexually Transmitted Infections Among Individuals Using HIV Preexposure Prophylaxis.
JAMA Intern Med
January 2025
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
Importance: Doxycycline postexposure prophylaxis (doxyPEP) has been shown to decrease the incidence of bacterial sexually transmitted infections (STIs) among people assigned male sex at birth in clinical trials, but data from clinical practice are limited.
Objective: To describe early uptake of doxyPEP and evaluate changes in STI incidence following doxyPEP initiation.
Design, Setting, And Participants: This retrospective cohort study of adults (aged ≥18 years) dispensed HIV preexposure prophylaxis (PrEP) at Kaiser Permanente Northern California during November 1, 2022, to December 31, 2023, examined electronic health record data to compare HIV PrEP users dispensed and not dispensed doxyPEP and rates of bacterial STIs before and after starting doxyPEP.
Oral Glucose-Lowering Agents vs Insulin for Gestational Diabetes: A Randomized Clinical Trial.
JAMA
January 2025
Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Importance: Metformin and glyburide monotherapy are used as alternatives to insulin in managing gestational diabetes. Whether a sequential strategy of these oral agents results in noninferior perinatal outcomes compared with insulin alone is unknown.
Objective: To test whether a treatment strategy of oral glucose-lowering agents is noninferior to insulin for prevention of large-for-gestational-age infants.
Doxycycline Postexposure Prophylaxis and Sexually Transmitted Infection Trends.
JAMA Intern Med
January 2025
San Francisco Department of Public Health, San Francisco, California.
Importance: Increasing rates of sexually transmitted infections (STIs) have been associated with rises in serious morbidity. While doxycycline postexposure prophylaxis (doxyPEP), a strategy in which individuals take doxycycline, 200 mg, after condomless sex to prevent bacterial STIs, has been shown to be efficacious in randomized clinical trials, doxyPEP's potential effect on population-level STI incidence is unknown.
Objective: To assess the association of citywide doxyPEP guideline release with reported chlamydia, gonorrhea, and early syphilis cases in men who have sex with men (MSM) and in transgender women in San Francisco, California.
Role of Social Determinants of Health in COVID-19 Recovery: A Qualitative Study.
JAMA Netw Open
January 2025
Department of Medicine, Duke University, Durham, North Carolina.
Importance: Health systems are increasingly required to conduct health-related social needs screening. However, how social resources negatively and positively affect recovery from acute illnesses, such as COVID-19, is incompletely understood.
Objective: To examine how social determinants of health (SDOH) influence recovery from COVID-19.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!