Using Neonatal Intensive Care Units More Wisely for At-Risk Newborns and Their Families

Abstract

Escalating US health care expenditures, including estimates that 20% to almost 50% of these costs involve processes, products, and services that do not improve outcomes, have brought renewed attention to the need to improve value in health care. 1 Among the 6 waste categories outlined by Berwick and Hackbarth, 1 there has been considerable focus on opportunities to reduce overtreatment, "the waste that comes from subjecting patients to care that… cannot possibly help them… rooted in outmoded habits, supply-driven behaviors, and ignoring science." Neonatal intensive care unit (NICU) services are at particularly high risk of overuse. Hospital and

The Effect of High Glucose Intake on Weight Gain in Very Low Birth Weight Neonates: A Randomized Controlled Trial

“…48 On the other hand, NICUs are claimed to be at high risk of overuse. 49 Accordingly, from a health economy standpoint, reducing the length of BW regain in VLBW neonates by 2 days could lower NICU usage and costs.…”

Examining the Relationship between Cost and Quality of Care in the Neonatal Intensive Care Unit and Beyond

“…This set of interventions and procedures adds to the list of other pediatric Choosing Wisely topics, has helped to escalate and continue the conversation of being health care stewards within Neonatology, and has led to large initiatives, such as Choosing Antibiotics Wisely by the Vermont Oxford Network (VON)-a national quality improvement initiative focused on reduction in unnecessary antibiotic exposure in newborns [11,12]. Amongst the next steps for health care stewardship within Neonatology is to figure out how to utilize neonatal care "more wisely" [13] to help combat the increasing trends in neonatal intensive care unit (NICU) admissions over time [14].…”

Logistic Regression as a Model for Assessing the Condition of Premature Newborns in Order to Transfer Them to Non-Invasive Respiratory Support

“…Однако принятие решения о переходе на неинвазивные методы лечения в настоящее время затруднено наличием многих недостаточно изученных факторов [5]. В результате врачи часто в таких случаях вынуждены при принятии решения также опираться на врачебный опыт и профессиональную интуицию, что может быть сопряжено с определенной долей ошибки.…”