Table 3. Association of Hospital-Level Neonatal Intensive Care Unit Beds per Live Births and Newborn Adverse Events, Texas Medicaid, 2010 to 2014.
| Beds per 100 live births | Adjusted risk ratios (95% CI)a | ||
|---|---|---|---|
| Very low birth weight (<1500 g) | Late preterm (34-36 wk) | Non-preterm (≥37 wk) | |
| Inpatient mortality | |||
| <0.50 | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 0.50 to <0.75 | 0.85 (0.70-1.04) | 1.00 (0.61-1.66) | 0.63 (0.43-0.94) |
| 0.75 to <1.00 | 0.84 (0.69-1.03) | 0.85 (0.50-1.44) | 0.57 (0.36-0.88) |
| 1.00 to <1.25 | 0.91 (0.74-1.13) | 0.79 (0.43-1.46) | 1.07 (0.66-1.71) |
| 1.25 to <1.50 | 0.67 (0.55-0.83) | 1.42 (0.86-2.34) | 1.15 (0.68-1.94) |
| 1.50 to <1.75 | 0.71 (0.57-0.90) | 1.10 (0.64-1.88) | 1.38 (0.91-2.09) |
| 1.75 to <2.00 | 0.65 (0.49-0.85) | 1.24 (0.70-2.20) | 1.25 (0.78-2.00) |
| ≥2.00 | 0.88 (0.70-1.11) | 1.45 (0.81-2.60) | 1.80 (1.17-2.75) |
| P for trendb | .95 | <.001 | <.001 |
| 30-d postdischarge adverse events | |||
| <0.50 | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 0.50 to <0.75 | 0.90 (0.72-1.12) | 0.99 (0.86-1.14) | 0.93 (0.82-1.04) |
| 0.75 to <1.00 | 0.95 (0.75-1.20) | 1.13 (0.99-1.29) | 1.02 (0.92-1.14) |
| 1.00 to <1.25 | 0.90 (0.71-1.15) | 1.05 (0.90-1.23) | 1.01 (0.88-1.18) |
| 1.25 to <1.50 | 1.01 (0.81-1.25) | 1.11 (0.97-1.26) | 1.13 (0.99-1.29) |
| 1.50 to <1.75 | 0.96 (0.75-1.23) | 1.19 (1.02-1.39) | 1.19 (1.01-1.40) |
| 1.75 to <2.00 | 1.06 (0.79-1.42) | 1.42 (1.19-1.69) | 1.42 (1.15-1.75) |
| ≥2.00 | 0.89 (0.69-1.16) | 1.14 (0.92-1.43) | 1.16 (0.92-1.47) |
| P for trendb | .16 | <.001 | <.001 |
Poisson generalized estimating equation models; newborn covariates were estimated inpatient mortality categories, diagnoses, procedures, congenital anomalies; hospital covariates were volume, profit status, and presence of neonatal fellowship. Inpatient mortality model for nonpreterm infants would not converge, so estimated mortality was specified as a continuous variable. Baseline rates for inpatient mortality were 11.76% (very low birth weight), 0.43% (late preterm), and 0.06% (nonpreterm). Baseline rates for 30-day postdischarge adverse events were 14.01% (very low birth weight), 9.24% (late preterm), and 6.67% (nonpreterms).
P value and direction of association from linear test of trend with capacity as a continuous variable. All statistically significant tests for trend indicate positive associations.