Quality, outcome, and cost of care provided to very low birth weight infants in California

Wannasiri Lapcharoensap, Mihoko Bennett, Xiao Xu, Henry C. Lee, Jochen Profit, Dmitry Dukhovny

Research output: Contribution to journalArticlepeer-review


Objective: To examine association of costs with quality of care and patient outcome across hospitals in California. Methods: Retrospective study of very low birth weight (VLBW) births from 2014–2018 linking birth certificate, hospital discharge records and clinical data. Quality was measured using the Baby-MONITOR score. Clinical outcome was measured using survival without major morbidity (SWMM). Hierarchical generalized linear models, adjusting for clinical factors, were used to estimate risk-adjusted measures of costs, quality, and outcome for each hospital. Association between these measures was evaluated using Pearson correlation coefficient. Results: In total, 15,415 infants from 104 NICUs were included. Risk-adjusted Baby-MONITOR score, SWMM rate, and costs varied substantially. There was no correlation between risk-adjusted cost and Baby-MONITOR score (r = 0, p = 0.998). Correlation between risk-adjusted cost and SWMM rate was inverse and not significant (r = −0.07, p = 0.48). Conclusions: With the metrics used, we found no correlation between cost, quality, and outcomes in the care of VLBW infants.

Original languageEnglish (US)
Pages (from-to)224-230
Number of pages7
JournalJournal of Perinatology
Issue number2
StatePublished - Feb 2024

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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