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Quantifying the variation in neonatal transport referral patterns using network analysis.

CPQCC Publication
TitleQuantifying the variation in neonatal transport referral patterns using network analysis.
Publication TypeJournal Article
Year of Publication2021
AuthorsKunz SN, Helkey D, Zitnik M, Phibbs CS, Rigdon J, Zupancic JAF, Profit J
JournalJ Perinatol
Date Published2021 May 25

OBJECTIVE: Regionalized care reduces neonatal morbidity and mortality. This study evaluated the association of patient characteristics with quantitative differences in neonatal transport networks.

STUDY DESIGN: We retrospectively analyzed prospectively collected data for infants <28 days of age acutely transported within California from 2008 to 2012. We generated graphs representing bidirectional transfers between hospitals, stratified by patient attribute, and compared standard network analysis metrics.

RESULT: We analyzed 34,708 acute transfers, representing 1594 unique transfer routes between 271 hospitals. Density, centralization, efficiency, and modularity differed significantly among networks drawn based on different infant attributes. Compared to term infants and to those transported for medical reasons, network metrics identify greater degrees of regionalization for preterm and surgical patients (more centralized and less dense, respectively [p < 0.001]).

CONCLUSION: Neonatal interhospital transport networks differ by patient attributes as reflected by differences in network metrics, suggesting that regionalization should be considered in the context of a multidimensional system.

Alternate JournalJ Perinatol
PubMed ID34035453
PubMed Central IDPMC8613294
Grant ListK08 HS025749 / HS / AHRQ HHS / United States