More than three out of four hospitals where high-risk, very-low birth weight babies are electively delivered before the onset of uterine contractions do not meet the Leapfrog Group's safety standards, according to a new report from the Leapfrog analyzed by Castlight Health.
The Leapfrog standards for elective delivery of high-risk, very-low birth weight infants are having an on-site or co-located neonatal intensive care unit, either admitting at least 50 very-low birth-weight babies annually or maintaining a better-than-expected standardized morbidity rate for the high-risk infants, and administering antenatal steroids to at least 80 percent of mothers at-risk for premature delivery.
Here are five findings to know from the Leapfrog report.
1. In 2016, only 23 percent of hospitals electively delivering high-risk, very-low birth weight babies met Leapfrog standards.
2. Alabama, Georgia, Indiana and Kansas were the top-performing states for high-risk delivery in 2016 with approximately 40 percent of their hospitals fully realizing Leapfrog standards.
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3. Oregon, South Carolina and Utah were the worst-performing states, according to the report. No hospital in any of the three states electively delivering these high-risk infants met Leapfrog standards.
4. NICU volume was found to vary significantly across hospitals in the same metro area. In Chicago, one hospital's NICU cared for 14 very-low birth weight infants in 2016, while another hospital's NICU just eight miles away cared for 849.
5. In 2016, 571 hospitals reported data on elective high-risk deliveries, marking an increase of 6 percent from the 537 hospitals that did so in 2015. However, just 17 percent of the newly reporting facilities met Leapfrog standards. The overall rate of hospitals complying with Leapfrog standards was 23 percent.
"There is a lot more work that needs to be done to provide better, safer care to mothers delivering a very-low birth weight baby in the U.S. healthcare system," said Leah Binder, president and CEO of the Leapfrog Group. "It's disheartening to see how many vulnerable babies are being delivered at hospitals that lack the optimal experience and environment to care for them. Hospitals that are not able to meet Leapfrog's standard should carefully reconsider electively performing these high-risk deliveries to avoid putting babies and mothers at risk."
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