Infant's race influences quality of NICU care, study finds

An infant's race and ethnicity influences the quality of medical care received in neonatal intensive care units in California, according to a recent study published in Pediatrics.

For the study, researchers from Stanford (Calif.) University School of Medicine analyzed care outcomes for 18,616 infants admitted to 134 NICUs in the state from 2010 through 2014. Researchers assessed the quality of care delivered at NICUs with a composite quality indicator consisting of nine measures, including growth velocity, the identification of a healthcare-associated bacterial or fungal infections and mortality. Researchers adjusted scores based on the mother's length of pregnancy, whether the mother received prenatal care and whether the child was part of a single or multiple birth.

The analysis revealed wide racial disparities in care quality. While the disparities were not uniform across hospitals, the hospitals with the best patient outcomes also delivered higher quality care to white infants. In low-performing NICUs, African-American infants received better care than white infants. Both African-American infants and Hispanic infants were more likely to receive care in lower-performing NICUs than white infants.

"There's a long history of disparity in healthcare delivery, and our study shows that the NICU is really no different," said the study's senior author, Jochen Profit, MD, associate professor of pediatrics at Stanford. "Unconscious social biases that we all have can make their way into the NICU. We would like to encourage NICU caregivers to think about how these disparities play out in their own units and how they can be reduced."

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