Quantification of EUGR as a Measure of the Quality of Nutritional Care of Premature Infants

Zhenlang Lin, Robert S Green, Shangqin Chen, Hui Wu, Tiantian Liu, Jingyang Li, Jia Wei and Jing Lin

PLOS ONE, 2015, vol. 10, issue 7, 1-10

Abstract: Objectives: To develop an index of the quality of nutritional care of premature infants based on the change in weight Z score from birth to discharge and to illustrate the use of this index in comparing the performance of different NICUs. Methods: Retrospective data analysis was performed to compare the growth of premature infants born in three perinatal centers. Infants with gestational age ≤ 32 weeks who survived to discharge from 2006 to 2010 were included. Weight Z scores at birth and discharge were calculated by the method of Fenton. Using data from one NICU as the reference, a multivariable linear regression model of change in weight Z score from birth to discharge was developed. Employing this model, a benchmark value of change in weight Z score was calculated for each baby. The difference between this calculated benchmark value and the baby’s observed change in weight Z score was defined as the performance gap for that infant. The average value of the performance gaps in a NICU serves as its quality care index. Results: 1,714 infants were included for analysis. Change in weight Z score is influenced by birth weight Z score and completed weeks of gestation; thus the model for calculating the benchmark change in weight Z score was adjusted for these two variables. We found statistically significant differences in the average performance gaps for the three units. Conclusions: A quality care index was developed based on change in weight Z score from birth to discharge adjusted for two initial risk factors. This objective, easily calculated index may be used as a measurement of the quality of nutritional care to rank the performance of different NICUs.

Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0132584

DOI: 10.1371/journal.pone.0132584

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