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 ResearchMeSH KeywordsCaliforniaCosts and Cost AnalysisHumansInfant, NewbornQuality ImprovementResuscitationSimulation TrainingConceptsNeonatal 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 costOutcomesCareIn Situ Simulation and Clinical Outcomes in Infants Born Preterm
Chitkara R, Bennett M, Bohnert J, Yamada N, Fuerch J, Halamek L, Quinn J, Padua K, Gould J, Profit J, Xu X, Lee H. In Situ Simulation and Clinical Outcomes in Infants Born Preterm. The Journal Of Pediatrics 2023, 263: 113715. PMID: 37659586, PMCID: PMC10841094, DOI: 10.1016/j.jpeds.2023.113715.Peer-Reviewed Original ResearchConceptsChronic lung diseaseClinical outcomesNeonatal resuscitationDelivery room continuous positive airway pressureVery low birth weight birthsNeonatal intensive care unit admissionCalifornia Perinatal Quality Care CollaborativeContinuous positive airway pressureVery low birth weightSecondary outcomesNeonatal intensive care unitInfants born pretermLow birth weight birthsSevere intraventricular hemorrhageIntensive care unit admissionPositive airway pressureLow birth weightInfant born pretermEvaluate clinical outcomesIntensive care unitParticipating sitesIntraventricular hemorrhageWeeks gestationBorn pretermCollaborative quality improvement project
2020
Hospital variation in admissions to neonatal intensive care units by diagnosis severity and category
Haidari ES, Lee HC, Illuzzi JL, Phibbs CS, Lin H, Xu X. Hospital variation in admissions to neonatal intensive care units by diagnosis severity and category. Journal Of Perinatology 2020, 41: 468-477. PMID: 32801351, PMCID: PMC7427695, DOI: 10.1038/s41372-020-00775-z.Peer-Reviewed Original ResearchMeSH KeywordsBirth WeightGestational AgeHospitalizationHospitalsHumansInfant, NewbornIntensive Care Units, NeonatalConceptsNeonatal intensive care unitNICU admission ratesIntensive care unitNICU admissionMild diagnosesCare unitHospital variationInterhospital variationAdmission ratesPatient/hospital characteristicsHospital discharge dataRisk-adjusted ratesWeeks' gestationNICU bedsBirth weightHospital characteristicsSevere diagnosisLive birthsMultivariable regressionAdmissionPotential overuseBirth certificatesDiagnosisHigher likelihoodDiagnosis severity
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 variation
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
2016
Variation in Hospital Intrapartum Practices and Association With Cesarean Rate
Lundsberg LS, Illuzzi JL, Gariepy AM, Sheth SS, Pettker CM, Lee HC, Lipkind HS, Xu X. Variation in Hospital Intrapartum Practices and Association With Cesarean Rate. Journal Of Obstetric Gynecologic & Neonatal Nursing 2016, 46: 5-17. PMID: 27886948, DOI: 10.1016/j.jogn.2016.07.011.Peer-Reviewed Original ResearchConceptsCesarean rateIntrapartum practicesIntrapartum interventionsIntrapartum careLow-risk womenLower cesarean ratesRegular reviewHospital cesarean rateCross-sectional surveyRank sum testKendall's tau-b correlation coefficientLiberal indicationsLabor inductionVaginal birthHospital variationNewborn careAntibody screenCesarean birthIntravenous lineObstetric servicesHospital characteristicsEligible hospitalsMassachusetts hospitalsFetal monitoringClinical staff