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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Baby-MONITOR: A composite indicator of NICU quality
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Baby-MONITOR: A composite indicator of NICU quality

机译：婴儿监护仪：NICU质量的综合指标

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BACKGROUND AND OBJECTIVES: NICUs vary in the quality of care delivered to very low birth weight (VLBW) infants. NICU performance on 1 measure of quality only modestly predicts performance on others. Composite measurement of quality of care delivery may provide a more comprehensive assessment of quality. The objective of our study was to develop a robust composite indicator of quality of NICU care provided to VLBW infants that accurately discriminates performance among NICUs. METHODS: We developed a composite indicator, Baby-MONITOR, based on 9 measures of quality chosen by a panel of experts. Measures were standardized, equally weighted, and averaged. We used the California Perinatal Quality Care Collaborative database to perform acrosssectional analysis of care given to VLBW infants between 2004 and 2010. Performance on the Baby-MONITOR is not an absolute marker of quality but indicates overall performance relative to that of the other NICUs. We used sensitivity analyses to assess the robustness of the composite indicator, by varying assumptions and methods. RESULTS: Our sample included 9023 VLBW infants in 22 California regional NICUs. We found significant variations within and between NICUs on measured components of the Baby-MONITOR. Risk-adjusted composite scores discriminated performance among this sample of NICUs. Sensitivity analysis that included different approaches to normalization, weighting, and aggregation of individual measures showed the Baby-MONITOR to be robust (r = 0.89-0.99). CONCLUSIONS: The Baby-MONITOR may be a useful tool to comprehensively assess the quality of care delivered by NICUs.
机译：背景和目的：重症监护病房在为极低出生体重（VLBW）婴儿提供的护理质量方面有所不同。 NICU在一项质量度量上的性能只能适度地预测其他性能。护理服务质量的综合衡量可以提供更全面的质量评估。我们研究的目的是开发一种强大的综合指标，用于为VLBW婴儿提供NICU护理质量，以准确地区分NICU之间的表现。方法：我们根据专家小组选择的9种质量度量标准，开发了一个综合指标Baby-MONITOR。衡量指标经过标准化，均等加权和平均。我们使用了加利福尼亚围产期质量护理协作数据库对2004年至2010年间对VLBW婴儿进行的护理进行了横断面分析。Baby-MONITOR的性能并不是绝对的质量指标，但可以表明相对于其他NICU的总体性能。我们通过各种假设和方法，使用敏感性分析来评估综合指标的稳健性。结果：我们的样本包括22个加利福尼亚州区域性重症监护病房中的9023名VLBW婴儿。我们在婴儿监护仪的被测组件上发现了重症监护病房内部和之间的重大差异。经风险调整的综合评分可区分此重症监护病房样本中的表现。敏感性分析包括不同的归一化，加权和单个度量聚合方法，表明Baby-MONITOR健壮（r = 0.89-0.99）。结论：婴儿监护仪可能是综合评估新生儿重症监护病房提供的护理质量的有用工具。

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