Though many U.S. hospitals electively deliver high-risk, low birth-weight babies, just 23% of hospitals that do so are equipped to care for such infants, according to a new analysis.
A report (PDF) from the Leapfrog Group and Castlight Health found that it was an issue across states, as no state had more than 40% of hospitals meet the group’s standards to treat highly vulnerable babies. Alabama, Indiana, Georgia and Kansas were the highest-performing states in 2016, while no hospitals that opted to perform high-risk births in Oregon, South Carolina or Utah met Leapfrog’s standards.
Leapfrog recommends that women who will give birth to low birth-weight babies do so at facilities that perform at least 50 such deliveries a year and have an experienced neonatal intensive care unit (NICU) either on-site or co-located. If patients can’t find a hospital that performs high numbers of high-risk births, Leapfrog recommends mothers look for facilities with lower-than-average mortality ratios, as measured by the Vermont-Oxford Network. Leapfrog’s standards also push hospitals to provide antenatal steroids to at least 80% of mothers at risk for a premature birth.
“There is a lot more work that needs to be done to provide better, safer care to mothers delivering a very-low birth weight baby in the U.S. healthcare system. It’s disheartening to see how many vulnerable babies are being delivered at hospitals that lack the optimal experience and environment to care for them,” Leah Binder, CEO of Leapfrog, said in a post announcing the report’s release.
Leapfrog also found that more hospitals are reporting that they will deliver high-risk babies, but these facilities also often fail to meet the group’s standards. Only 17% of the 98 hospitals that reported to Leapfrog that they performed high-risk deliveries in 2016 (but did not do so in 2015) met Leapfrog’s standards.
NICU volume, one of the key measures of preparedness for high-risk deliveries, can also vary widely within the same city, the report found. The difference was stark, for instance, when comparing two Chicago hospitals, just 8 miles apart: One facility performed nearly 850 high-risk births in 2016, with the other performed just 14.