title: Association of unit size, resource utilization and occupancy with outcomes of preterm infants.
abstract: OBJECTIVE
  Assess association of NICU size, and occupancy rate and resource utilization at admission with neonatal outcome.
  
  
  METHODS
  Retrospective cohort study of 9978 infants born at 23-32 weeks gestation and admitted to 23 tertiary-level Canadian NICUs during 2010-2012. Adjusted odds ratios (AOR) were estimated for a composite outcome of mortality/any major morbidity with respect to NICU size, occupancy rate and intensity of resource utilization at admission.
  
  
  RESULTS
  A total of 2889 (29%) infants developed the composite outcome, the odds of which were higher for 16-29, 30-36 and >36-bed NICUs compared with <16-bed NICUs (AOR (95% CI): 1.47 (1.25-1.73); 1.49 (1.25-1.78); 1.55 (1.29-1.87), respectively) and for NICUs with higher resource utilization at admission (AOR: 1.30 (1.08-1.56), Q4 vs Q1) but not different according to NICU occupancy.
  
  
  CONCLUSIONS
  Larger NICUs and more intense resource utilization at admission are associated with higher odds of a composite adverse outcome in very preterm infants.
authors: 1] Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada [2] Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors: P S
authors: PS
authors: Shah
authors: 1] Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada [2] Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors: L
authors: L
authors: Mirea
authors: Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors: E
authors: E
authors: Ng
authors: Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
authors: A
authors: A
authors: Solimano
authors: 1] Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada [2] Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors: S K
authors: SK
authors: Lee
mesh_terms: D001509:Bed Occupancy; D002170:Canada; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006742:Hospital Bed Capacity; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000401:mortality; D007236:Infant, Small for Gestational Age; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D012189:Retrospective Studies