Abstract
Aim: To describe how variation in care influences distribution of health services to newborn infants in Norway.
Methods: Data from the Norwegian Neonatal Registry covering nearly 100% of all neonatal intensive care unit (NICU) admissions in Norway were analyzed. Healthcare utilization was counted per 1000 births stratified for gestational age according to hospital referral areas defined by the hospital providing the majority of services. Data are presented as coefficients of variation and extremal ratios between the highest and lowest rate.
Results: There is a significant geographic variation in hospital admission rates, mechanical ventilation antibiotic use, diagnostic practice, and use of intensive care treatment. Variation in admission rates is low in infants born before 34 weeks of gestational age and increases with increasing gestational age.
Conclusion: Variation in healthcare utilization of the magnitude described cannot be explained by differences in morbidity or patient preferences and may therefore be described as unwarranted variation. Individual or local preferences and supply of resources may better explain the observed variation
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Acknowledgments
Thanks to my collaborators Arild Rønnestad and Hans Jørgen Stensvold in the Norwegian Neonatal Network and Bård Uleberg, Frank Olsen, and Hanne Sigrun Byhring at the Center for Clinical Evaluation and Documentation for contributing with data, analysis, and publishing of the Norwegian Neonatal Health Care Atlas and to Professor David Goodman at the Dartmouth Institute for Health Policy & Clinical Practice for encouragement and for including data from our atlas into the Dartmouth Atlas of Neonatal Intensive Care.
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Moen, A. (2022). The Norwegian Neonatal Healthcare Atlas. In: Schulman, J. (eds) The Problem of Practice Variation in Newborn Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-94655-5_8
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DOI: https://doi.org/10.1007/978-3-030-94655-5_8
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