2024
Implementation of a multi-site neonatal simulation improvement program: a cost analysis
Xu X, Yao J, Bohnert J, Yamada N, Lee H. Implementation of a multi-site neonatal simulation improvement program: a cost analysis. BMC Health Services Research 2024, 24: 623. PMID: 38741098, PMCID: PMC11090826, DOI: 10.1186/s12913-024-11075-z.Peer-Reviewed Original ResearchConceptsNeonatal resuscitation trainingCalifornia Perinatal Quality Care CollaborativePre-implementation periodResuscitation trainingParticipating sitesPre-implementationNon-financial benefitsSuccessful programsConfidence intervalsMonthly costProgram implementation periodImprovement programsData collection formQuality Improvement ProgramMicro-costing approachCost accountingCare CollaborativeHealthcare sector perspectiveAssist hospitalsU.S. dollarsImplementation periodTeam practiceCollection formMean costTraining curriculum
2023
Quality, outcome, and cost of care provided to very low birth weight infants in California
Lapcharoensap W, Bennett M, Xu X, Lee H, Profit J, Dukhovny D. Quality, outcome, and cost of care provided to very low birth weight infants in California. Journal Of Perinatology 2023, 44: 224-230. PMID: 37805592, DOI: 10.1038/s41372-023-01792-4.Peer-Reviewed Original ResearchConceptsVery low birth weightCare of VLBW infantsLow birth weightRisk-adjusted costVLBW infantsQuality of careMethodsRetrospective studyBirth weightClinical outcomesHospital discharge recordsClinical factorsCost of careClinical dataHierarchical generalized linear modelsResultsIn totalBirth certificatesPatient outcomesInfantsPearson correlation coefficientAssociation of costDischarge recordsHospitalMeasures of costOutcomesCare
2020
Trial of Labor After Two Prior Cesarean Deliveries: Patient and Hospital Characteristics and Birth Outcomes.
Dombrowski M, Illuzzi JL, Reddy UM, Lipkind HS, Lee HC, Lin H, Lundsberg LS, Xu X. Trial of Labor After Two Prior Cesarean Deliveries: Patient and Hospital Characteristics and Birth Outcomes. Obstetrics And Gynecology 2020, 136: 109-117. PMID: 32541284, PMCID: PMC7321852, DOI: 10.1097/aog.0000000000003845.Peer-Reviewed Original ResearchConceptsComposite severe maternal morbidityTrial of laborPrior cesarean deliverySevere maternal morbidityCesarean deliveryMaternal morbidityNewborn complicationsHospital characteristicsPropensity score-matched analysisSevere neonatal morbiditySuccessful vaginal birthSingleton live birthsAssociation of patientCohort of mothersBirth certificate dataSample eligibility criteriaModest increaseNeonatal morbidityNeonatal outcomesHospital dischargeBirth outcomesVaginal birthClear contraindicationsLive birthsMultivariable regression
2019
Low‐Interventional Approaches to Intrapartum Care: Hospital Variation in Practice and Associated Factors
Lundsberg LS, Main EK, Lee HC, Lin H, Illuzzi JL, Xu X. Low‐Interventional Approaches to Intrapartum Care: Hospital Variation in Practice and Associated Factors. Journal Of Midwifery & Women's Health 2019, 65: 33-44. PMID: 31502407, DOI: 10.1111/jmwh.13017.Peer-Reviewed Original ResearchConceptsIntrapartum careMultivariable logistic regressionHigh intervention groupLow-intervention groupMedical-legal concernsIntrapartum practicesNewborn morbidityHospital variationCesarean birthAssociated FactorsPatient outcomesInterventional approachesProcedure ratesAmerican CollegeHospital useHospital's likelihoodHospital groupHospitalBivariate analysisLogistic regressionMidwifery modelCalifornia hospitalsCareLatent class analysisHospital culture
2018
Hospital variation in utilization and success of trial of labor after a prior cesarean
Xu X, Lee HC, Lin H, Lundsberg LS, Campbell KH, Lipkind HS, Pettker CM, Illuzzi JL. Hospital variation in utilization and success of trial of labor after a prior cesarean. American Journal Of Obstetrics And Gynecology 2018, 220: 98.e1-98.e14. PMID: 30278176, DOI: 10.1016/j.ajog.2018.09.034.Peer-Reviewed Original ResearchMeSH KeywordsAdultCaliforniaCesarean SectionCohort StudiesDatabases, FactualFemaleGestational AgeHospitals, High-VolumeHospitals, Low-VolumeHumansInfant, NewbornMaternal AgePatient SafetyPregnancyPregnancy OutcomeRetrospective StudiesRisk AssessmentTrial of LaborUterine RuptureVaginal Birth after CesareanConceptsSuccess of trialCesarean deliveryTrial of laborHospital variationSuccess rateLow success rateNewborn hospital discharge recordsPatient clinical risk factorsSevere unexpected newborn complicationsNewborn respiratory complicationsUnexpected newborn complicationsClinical risk factorsPrior cesarean deliveryHospital discharge recordsPatient case mixBirth certificate dataMidwife-attended birthsAnesthesia availabilityNewborn infectionRespiratory complicationsUterine ruptureNewborn morbidityPrior cesareanNewborn complicationsVaginal birthOptimal maternal and neonatal outcomes and associated hospital characteristics
Campbell KH, Illuzzi JL, Lee HC, Lin H, Lipkind HS, Lundsberg LS, Pettker CM, Xu X. Optimal maternal and neonatal outcomes and associated hospital characteristics. Birth 2018, 46: 289-299. PMID: 30251270, DOI: 10.1111/birt.12400.Peer-Reviewed Original ResearchMeSH KeywordsAdultBirth CertificatesCaliforniaCesarean SectionFemaleGestational AgeHospitalsHumansInfant, NewbornInfant, Newborn, DiseasesMorbidityObstetric Labor ComplicationsObstetricsPatient DischargePoisson DistributionPregnancyQuality Indicators, Health CareRegression AnalysisRisk FactorsYoung AdultConceptsRisk-standardized ratesMorbidity rateNeonatal outcomesObstetrical performancePatient clinical risk factorsFuture quality improvement effortsMaternal morbidity ratesNeonatal morbidity ratesProcedures/surgeriesSevere newborn morbiditySevere maternal morbidityClinical risk factorsShock/resuscitationHospital discharge recordsMaternal-newborn outcomesQuality improvement effortsPrevalent morbidityMaternal morbidityNeonatal morbidityRespiratory complicationsIntravascular coagulationNewborn morbidityHeart failureTerm birthsHospital variationQuality Assurance Practices in Obstetric Care
Lundsberg LS, Lee HC, Dueñas GV, Gregory KD, Nardini H, Pettker CM, Illuzzi JL, Xu X. Quality Assurance Practices in Obstetric Care. Obstetrics And Gynecology 2018, 131: 214-223. PMID: 29324608, PMCID: PMC7020098, DOI: 10.1097/aog.0000000000002437.Peer-Reviewed Original ResearchConceptsAbnormal fetal heart rateEvidence-supported practicesFetal heart rateObstetric careHeart rateFrequent simulationLabor arrestCesarean deliveryPostpartum hemorrhageSignificant morbidityObstetric hospitalPerinatal careShoulder dystociaAppropriate statistical testsHospital practiceHospitalBivariate analysisTeaching statusMost hospitalsCareEclampsiaPrivate nonprofit hospitalsInterprofessional simulationStatewide surveyBroad spectrum
2017
Hospital variation in cost of childbirth and contributing factors: a cross‐sectional study
Xu X, Lee H, Lin H, Lundsberg L, Pettker C, Lipkind H, Illuzzi J. Hospital variation in cost of childbirth and contributing factors: a cross‐sectional study. BJOG An International Journal Of Obstetrics & Gynaecology 2017, 125: 829-839. PMID: 29090498, DOI: 10.1111/1471-0528.15007.Peer-Reviewed Original ResearchConceptsChildbirth hospitalisationsHospital variationObstetric interventionsHospital variancePatient clinical risk factorsSevere maternal morbiditySevere newborn morbidityClinical risk factorsMaternal sociodemographic characteristicsHospital discharge dataCross-sectional studyUrban-rural statusCross-sectional analysisCosts of childbirthHigh-cost hospitalsVertex birthsMaternal morbidityCaesarean deliveryNewborn morbidityBirth attendantsRisk factorsHospital typeCare capacityHospitalisationBetter outcomes