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Disparities in NICU quality of care: a qualitative study of family and clinician accounts.

TitleDisparities in NICU quality of care: a qualitative study of family and clinician accounts.
Publication TypeJournal Article
Year of Publication2018
AuthorsSigurdson K, Morton C, Mitchell B, Profit J
JournalJ Perinatol
Date Published2018 05
KeywordsEthnic Groups, Female, Gender Identity, Health Equity, Healthcare Disparities, Humans, Intensive Care Units, Neonatal, Intensive Care, Neonatal, Language, Male, Minority Groups, Qualitative Research, Quality of Health Care, Surveys and Questionnaires, Vermont

OBJECTIVE: To identify how family advocates and clinicians describe disparities in NICU quality of care in narrative accounts.

STUDY DESIGN: Qualitative analysis of a survey requesting disparity stories at the 2016 VON Quality Congress. Accounts (324) were from a sample of RNs (n = 114, 35%), MDs (n = 109, 34%), NNPs (n = 55, 17%), RN other (n = 4, 1%), clinical other (n = 25, 7%), family advocates (n = 16, 5%), and unspecified (n = 1, <1%).

RESULTS: Accounts (324) addressed non-exclusive disparities: 151 (47%) language; 97 (30%) culture or ethnicity; 72 (22%) race; 41 (13%) SES; 28 (8%) drug use; 18 (5%) immigration status or nationality; 16 (4%) sexual orientation or family status; 14 (4%) gender; 10 (3%) disability. We identified three types of disparate care: neglectful care 85 (26%), judgmental care 85 (26%), or systemic barriers to care 139 (44%).

CONCLUSIONS: Nearly all accounts described differential care toward families, suggesting the lack of equitable family-centered care.

Alternate JournalJ Perinatol
PubMed ID29622778
PubMed Central IDPMC5998372
Grant ListR01 HD083368 / HD / NICHD NIH HHS / United States