Mortality among very low-birthweight infants in hospitals serving minority populations.
OBJECTIVE
We investigated whether the proportion of Black very low-birth-weight (VLBW) infants treated by hospitals is associated with neonatal mortality for Black and White VLBW infants.


METHODS
We analyzed medical records linked to secondary data sources for 74050 Black and White VLBW infants (501 g to 1500 g) treated by 332 hospitals participating in the Vermont Oxford Network from 1995 to 2000. Hospitals where more than 35% of VLBW infants treated were Black were defined as "minority-serving."


RESULTS
Compared with hospitals where less than 15% of the VLBW infants were Black, minority-serving hospitals had significantly higher risk-adjusted neonatal mortality rates (White infants: odds ratio [OR]=1.30, 95% confidence interval [CI] = 1.09, 1.56; Black infants: OR = 1.29, 95% CI = 1.01, 1.64; Pooled: OR = 1.28, 95% CI=1.10, 1.50). Higher neonatal mortality in minority-serving hospitals was not explained by either hospital or treatment variables.


CONCLUSIONS
Minority-serving hospitals may provide lower quality of care to VLBW infants compared with other hospitals. Because VLBW Black infants are disproportionately treated by minority-serving hospitals, higher neonatal mortality rates at these hospitals may contribute to racial disparities in infant mortality in the United States.
Morales
Leo S
LS
University of California Los Angeles, USA. morales@rand.org
Staiger
Douglas
D
Horbar
Jeffrey D
JD
Carpenter
Joseph
J
Kenny
Michael
M
Geppert
Jeffrey
J
Rogowski
Jeannette
J
D001741:Black or African American; D019992:Databases as Topic; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008913:Minority Groups; D009096:Multi-Institutional Systems; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology; D044465:White People