title: Variations and Determinants of Mortality and Length of Stay of Very Low Birth Weight and Very Low for Gestational Age Infants in Seven European Countries.
abstract: The EuroHOPE very low birth weight and very low for gestational age infants study aimed to measure and explain variation in mortality and length of stay (LoS) in the populations of seven European nations (Finland, Hungary, Italy (only the province of Rome), the Netherlands, Norway, Scotland and Sweden). Data were linked from birth, hospital discharge and mortality registries. For each infant basic clinical and demographic information, infant mortality and LoS at 1 year were retrieved. In addition, socio-economic variables at the regional level were used. Results based on 16,087 infants confirm that gestational age and Apgar score at 5 min are important determinants of both mortality and LoS. In most countries, infants admitted or transferred to third-level hospitals showed lower probability of death and longer LoS. In the meta-analyses, the combined estimates show that being male, multiple births, presence of malformations, per capita income and low population density are significant risk factors for death. It is essential that national policies improve the quality of administrative datasets and address systemic problems in assigning identification numbers at birth. European policy should aim at improving the comparability of data across jurisdictions.
authors.affiliation: Centre for Research on Health and Social Care Management, CERGAS, Bocconi University, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fatttore
authors.affiliation: Centre for Research on Health and Social Care Management, CERGAS, Bocconi University, Milan, Italy.|Department of Sociology,Faculty of Social Sciences, Charles University, Prague, Czech Republic.
authors.forename: Dino
authors.initials: D
authors.lastname: Numerato
authors.affiliation: National Institute for Health and Welfare, Centre for Health and Social Economics CHESS, Helsinki, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Peltola
authors.affiliation: Centre for Research on Health and Social Care Management, CERGAS, Bocconi University, Milan, Italy.
authors.forename: Helen
authors.initials: H
authors.lastname: Banks
authors.affiliation: Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy.|Carlo F. Dondena Centre for Research on Social Dynamics, Bocconi University, Milan, Italy.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Graziani
authors.affiliation: National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: Heijink
authors.affiliation: National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Eelco
authors.initials: E
authors.lastname: Over
authors.affiliation: Department of Health Management and Health Economics, University of Oslo, Oslo, Norway.
authors.forename: Søren Toksvig
authors.initials: ST
authors.lastname: Klitkou
authors.affiliation: Lothian Analytical Services, NHS Lothian, Edinburgh, UK.
authors.forename: Eilidh
authors.initials: E
authors.lastname: Fletcher
authors.affiliation: Semmelweis University, Budapest, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Mihalicza
authors.affiliation: Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sofia
authors.initials: S
authors.lastname: Sveréus
mesh_terms: D005060:Europe / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007902:Length of Stay; D008297:Male; D011247:Pregnancy; D012042:Registries; D012307:Risk Factors
keywords: Finland; Hungary; Italy; Norway; Sweden; length of stay; mortality; regional variation; the Netherlands; very low birth weight infants; very preterm infants