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Objective(s):To identify predictors of home oxygen use in preterm infants with bronchopulmonary dysplasia in a statewide cohort, identify hospital variation in home oxygen use, and determine the relationship between home oxygen use and NICU discharge timing. Study design:This was a secondary analysis of California Perinatal Quality Care Collaborative data. Infants were born <32 weeks' gestation, diagnosed with bronchopulmonary dysplasia based on respiratory support at 36 weeks postmenstrual age, and discharged home. Risk factors for home oxygen use were identified using a logistic mixed model with center as random effect. Estimates were used to calculate each center's observed to expected ratio of home oxygen use, and a Spearman coefficient between center median postmenstrual age at discharge and observed and expected proportions of home oxygen use.Results: 3672/7846 (47%) infants with bronchopulmonary dysplasia were discharged with home oxygen. Higher odds of home oxygen use were seen with antenatal steroids, maternal hypertension, earlier gestational age, male sex, ductus arteriosus ligation, more ventilator days, nitric oxide, discharge from regional hospitals, and postmenstrual age at discharge (ROC area under the curve 0.85). Of 92 hospitals, home oxygen use ranged from 7-95%; 42% of observed home oxygen use was significantly higher or lower than expected given patient characteristics. The 67 community hospitals with higher observed rates of home oxygen had earlier median postmenstrual age at discharge (correlation −0.27, p=0.024). Conclusion:Clinical and hospital factors predict home oxygen use. Home oxygen use varies across California, with community centers using more home oxygen having a shorter length of stay.

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