Intensive-care inequities

The quality of neonatal intensive care in California is inconsistent across racial and ethnic groups, according to a Stanford examination of the care of more than 18,000 of the state’s smallest babies at 134 hospitals.

“There’s a long history of disparity in health care delivery, and our study shows that the NICU is really no different,” says the study’s senior author, Jochen Profit, MD, associate professor of pediatrics.

At some California hospitals, infants from vulnerable populations received worse care than white infants, while at others, they received better care. In general, the hospitals with the best outcomes for their patients also delivered better care to white infants. In addition, the study found that black and Hispanic infants were more likely than white infants to receive care in poor-quality NICUs.

The study, using data from the California Perinatal Quality Care Collaborative, was published Aug. 28 in Pediatrics and considered overall standards of care and whether they were met, overall quality of care at individual hospitals and health outcomes for the babies. Addressing the disparities will require a nuanced approach, Profit says.

“It’s really important for NICUs to individualize care to the patient population they see,” he says.