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Comparison of state risk-appropriate neonatal care policies with the 2012 AAP policy statement

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Abstract

Objective

Compare state policies with standards outlined in the 2012 AAP Policy Statement on Levels of Neonatal Care.

Study design

Systematic, web-based review of publicly available policies on levels of care in all states in 2014. Infant risk information, equipment capabilities, and specialty staffing were abstracted from published rules, statutes, and regulations.

Result

Twenty-two states had a policy on regionalized perinatal care. State policies vary in consistency with the AAP Policy, with 60% of states including standards consistent with Level I criteria, 48% Level II, 14% Level III, and one state with Level IV. Ventilation capability standards are highly consistent (66–100%), followed by imaging capability standards (50–90%). Policy language on specialty staffing (44–68%), and subspecialty staffing (39–50%) are moderately consistent.

Conclusion

State policies vary in consistency, a potentially significant barrier to monitoring, regulation, uniform care provision and measurement, and reporting of national-level measures on risk-appropriate care.

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Acknowledgements

We would like to acknowledge the data abstractors for contributing to the body of this work: Mary Charlotte Tate, Kim Tubbs Ramsay, Renyea M. Colvin, MPH, and Tracie Herold, LCSW. We would also like to thank Evelyn Interis, MPH, and Amy M. Williams, MPH, for the literature search and review, and Elizabeth Martin for facilitating management and coordination of the data abstractors and researchers. Finally, we would like to acknowledge the contributions of Alex Monroe Smith, who validated the data tables for this paper.

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Authors and Affiliations

  1. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, Georgia

    Charlan D. Kroelinger, Ekwutosi M. Okoroh, David A. Goodman & Wanda D. Barfield

  2. Independent Consultant, Atlanta, GA, Georgia

    Sarah M. Lasswell

Authors
  1. Charlan D. Kroelinger
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  2. Ekwutosi M. Okoroh
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  3. David A. Goodman
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Correspondence to Charlan D. Kroelinger.

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Kroelinger, C.D., Okoroh, E.M., Goodman, D.A. et al. Comparison of state risk-appropriate neonatal care policies with the 2012 AAP policy statement. J Perinatol 38, 411–420 (2018). https://doi.org/10.1038/s41372-017-0006-6

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  • DOI: https://doi.org/10.1038/s41372-017-0006-6

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