title: Hospital differences in special care nursery use for newborns of gestational diabetic mothers.
abstract: OBJECTIVE
  Relatively healthy newborns of mothers with gestational diabetes mellitus (GDM) sometimes receive unwarranted surveillance. We studied the relationship between hospital characteristics and special care nursery use and total length of stay among GDM deliveries.
  
  
  METHODS
  We identified GDM deliveries at 44 USA member hospitals of the National Perinatal Information Center from 2007 to 2011. To study low risk, relatively healthy newborns with presumed discretion in special care nursery use, we analyzed 43 444 singleton newborns with only minor or moderate complications and WHO were not preterm or low birthweight.
  
  
  RESULTS
  Among eligible newborns, 6% received special care, but this ranged from 1% to 16% across 44 hospitals studied. Unadjusted associations suggested special care nursery use was highest in academic teaching hospitals, the Midwest, hospitals with ≥40% Medicaid births, and hospitals with a high supply of special care nursery beds. However, after controlling for clustering within hospitals, there were no significant associations between hospital characteristics and special care nursery use or length of stay.
  
  
  CONCLUSIONS
  Hospital-level variation in special care nursery use and length of stay of relatively healthy newborns of mothers with GDM is unexplained by hospital characteristics and suggests other operational or management factors impacting utilization of newborn care resources.
authors.affiliation: a Department of Epidemiology , Brown University School of Public Health , Providence , RI , USA .|b National Perinatal Information Center/Quality Analytic Services , Providence , RI , USA .|c Division of Research , Women & Infants Hospital , Providence , RI , USA , and.
authors.forename: Valery A
authors.initials: VA
authors.lastname: Danilack
authors.affiliation: b National Perinatal Information Center/Quality Analytic Services , Providence , RI , USA .
authors.forename: Janet H
authors.initials: JH
authors.lastname: Muri
authors.affiliation: a Department of Epidemiology , Brown University School of Public Health , Providence , RI , USA .|d Department of Obstetrics and Gynecology , Warren Alpert Medical School of Brown University , Providence , RI , USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
authors.affiliation: b National Perinatal Information Center/Quality Analytic Services , Providence , RI , USA .
authors.forename: Donna L
authors.initials: DL
authors.lastname: Caldwell
authors.affiliation: b National Perinatal Information Center/Quality Analytic Services , Providence , RI , USA .
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Wood
mesh_terms: D016640:Diabetes, Gestational; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D000069342:Medical Overuse / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D009725:Nurseries, Hospital / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011247:Pregnancy; D014481:United States
keywords: Gestational diabetes; hospitals; length of stay; neonatal intensive care