title: [Risk-adjusted assessment: late-onset infection in neonates].
abstract: OBJECTIVE
  The weak point of the countrywide perinatal/neonatal quality surveillance is the ignorance of interhospital differences in the case mix of patients. As a result, this approach does not produce reliable benchmarking. The objective of this study was to adjust the result of the late-onset infection incidence of different hospitals according to their risk profile of patients by multivariate analysis.
  
  
  METHODS
  The perinatal/neonatal database of 41,055 newborns of the Saxonian quality surveillance from 1998 to 2004 was analysed. Based on 18 possible risk factors, a logistic regression model was used to develop a specific risk predictor for the quality indicator "late-onset infection".
  
  
  RESULTS
  The developed risk predictor for the incidence of late-onset infection could be described by 4 of the 18 analysed risk factors, namely gestational age, admission from home, hypoxic ischemic encephalopathy and B-streptococcal infection. The AUC(ROC) value of this quality indicator was 83.3%, which demonstrates its reliability. The hospital ranking based on the adjusted risk assessment was very different from hospital rankings before this adjustment. The average correction of ranking position was 4.96 for 35 clinics.
  
  
  CONCLUSIONS
  The application of the risk adjustment method proposed here allows for a more objective comparison of the incidence of the quality indicator "late onset infection" among different hospitals.
authors.affiliation: Arbeitsgruppe Qualitätssicherung Perinatologie/Neonatologie der Sächsischen Landesärztekammer. dgmyrek@web.de
authors.forename: Dieter
authors.initials: D
authors.lastname: Gmyrek
authors.forename: Rainer
authors.initials: R
authors.lastname: Koch
authors.forename: Christoph
authors.initials: C
authors.lastname: Vogtmann
authors.forename: Annette
authors.initials: A
authors.lastname: Kaiser
authors.forename: Annette
authors.initials: A
authors.lastname: Friedrich
mesh_terms: D019985:Benchmarking / Q000592:standards*; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D005865:Gestational Age; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008297:Male; D010343:Patient Admission; D011247:Pregnancy; D011272:Pregnancy, Multiple; D019984:Quality Indicators, Health Care / Q000592:standards*; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D013292:Streptococcus agalactiae