Changes in hospital quality at hospitals serving black and hispanic newborns below 30 weeks' gestation

OBJECTIVE: Examine whether the quality of Black and Hispanic serving (BHS) compared with not BHS (NBHS) NICUs has changed differentially over time. STUDY DESIGN: Infants 24–29 weeks’ gestation born at U.S. Vermont Oxford Network centers (2006–2018) were studied. We calculated adjusted hospital quality scores as the predicted probabilities of composite in-hospital mortality and morbidities from a logistic model. We regressed hospital quality scores on birth year to estimate the linear temporal slope by BHS-serving status for hospitals within each Census division. RESULTS: Hospital quality improved similarly over time for BHS and NBHS hospitals across all divisions except West South Central where a mean change in the composite score was −18.8 (95% CI: −24.1, −13.5) for NBHS and −9.3 (95% CI: −14.1, −4.6) for BHS hospitals (p-value = 0.009). CONCLUSION: Hospital quality improved similarly for BHS and NBHS hospitals across most divisions. Variation within and between divisions should be a focus for quality improvement.