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Editorial
January 2018

Data Deficiency in an Era of Expanding Neonatal Intensive Care Unit Care

Author Affiliations
  • 1The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
  • 2Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
  • 3Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
JAMA Pediatr. 2018;172(1):11-12. doi:10.1001/jamapediatrics.2017.4042

Despite longstanding efforts to improve newborn care, the ability of neonatology and the public to monitor and influence the quality, outcomes, and efficiency of care has been mixed. On the bright side, the Vermont-Oxford Network has pioneered the comparative measurement of care processes and outcomes primarily for very low-birth-weight newborns through benchmarking, research, and quality improvement initiatives. Statewide perinatal collaborative efforts, most notably the California Perinatal Quality Care Collaborative and the California Children’s Services (CPQCC/CCS), have expanded the range of newborn care data and provided further stimulus to improvement activities. While these efforts remain important, the growth of neonatal intensive care unit (NICU) care has overtaken these data used by these initiatives, leaving the care and outcomes of most newborns in the dark. Currently, to our knowledge, no entity is responsible or has the means to monitor medical care for the total birth cohort in the United States, and only limited data sets are available at the state level.

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