Escobar, Gabriel J.
Research interests include the outcomes of neonatal intensive care.
Kuzniewicz, Michael W
Research interests include perinatal health services research and perinatal clinical epidemiology
Reducing Variation in Hospitalization and Processes of Care in Emergency Department Patients with Atrial Fibrillation: A Stepped Wedge Cluster Randomized Trial
This stepped-wedge cluster randomized trial will stagger implementation of a clinical decision support system (CDSS) across 13 KPNC emergency departments…
Preventing COPD readmissions under the Hospital Readmissions Reduction Program: How far have we come?
The Hospital Readmissions Reduction Program (HRRP) was developed and implemented by the Centers for Medicare & Medicaid Services to curb…
Hospital Characteristics and Breast Cancer Survival in the California Breast Cancer Survivorship Consortium
Racial/ethnic disparities in breast cancer survival are well documented, but the influence of health care institutions is unclear. We therefore…
Hospital Alternatives (HALT)
The SRI team will (a) assess results of previous internal and external deployments of alternatives to hospitalization, (b) define strategies…
Development, Reevaluation, and Implementation of Outcome/Efficiency Measures for Hospital and Eligible Clinicians
The goal of this project is to assist with measure development and testing for the Hospital-Wide Mortality (HWM) hybrid and…
Primary Care Physicians’ Experiences With and Strategies for Managing Electronic Messages
The increasing use of electronic communications has enhanced access to physicians for patients and clinical staff. Primary care physicians (PCPs)…
Improving Outcomes and Care Experience among Dual-Eligible Members
This study will be one of the first to examine the relationship between health-system factors across the continuum of care…
Association of Medical Scribes in Primary Care With Physician Workflow and Patient Experience
Widespread adoption of electronic health records (EHRs) in medical care has resulted in increased physician documentation workload and decreased interaction…
Targeting Cardiovascular Events to Improve Patient Outcomes After Sepsis
Sepsis is the most common illness leading to hospitalization in the United States, affecting more than 1 million Americans each…
Impact of an electronic medical record reminder on hepatitis B vaccine initiation and completion rates among insured adults with diabetes mellitus
The Advisory Committee on Immunization Practices recommends Hepatitis B (HepB) vaccine for previously unvaccinated adults
Inpatient electronic health record maintenance from 2010 to 2015
To describe the scale and scope of inpatient electronic health record (EHR) maintenance following initial implementation. A retrospective study reviewing EHR…
Increasing Safe Outpatient Management of Emergency Department Patients With Pulmonary Embolism: A Controlled Pragmatic Trial
Many low-risk patients with acute pulmonary embolism (PE) in the emergency department (ED) are eligible for outpatient care but are…
Population-Based Pharmacogenomic Assessment of QT Prolongation
Cardiotoxicity of commonly prescribed medications, typically assessed by electrocardiographic features such as prolongation of the QT interval, has regulatory effects…
Benchmarking Hospital Quality – Template Matching
In this study, Kaiser Permanente Northern California researchers will serve as consultants for U.S. Department of Veterans Affairs (VA) researchers…
It Takes a Network: A Network Science- and Command Center-Based Approach to Hospital Error Detection, Prevention, and Mitigation
This project aims to develop a set of algorithms for generic error detection, prevention, and mitigation in the hospital setting.…
The Implementation of Performance Management Systems in U.S. Physician Organizations
Performance management systems (PMSYS) aid in improving the quality and efficiency of care, but little is known about factors that…
Characterization of Statin Low-Density Lipoprotein Cholesterol Dose-Response Using Electronic Health Records in a Large Population-Based Cohort
Low-density lipoprotein cholesterol (LDL-C) response to statin therapy has not been fully elucidated in real-world populations. The primary objective of…
Agreement between medical records and self-reports: Implications for transgender health research
A key priority of transgender health research is the evaluation of long-term effects of gender affirmation treatment. Thus, accurate assessment…
Association of behavioral health factors and social determinants of health with high and persistently high healthcare costs
A high proportion of U.S. health care costs are attributable to a relatively small proportion of patients. Understanding behavioral and…
Social and Functional Predictors of Rehospitalization: YCLS and PROMIS (SDH2)
This project aims to determine whether fields included in the National Institutes of Health’s Patient Reported Outcomes Measurement System (PROMIS)…
Evaluation of the Effectiveness and Implementation of Regionalized Care of Testicular Cancer
This study has three primary aims: 1) to evaluate the effectiveness of Testicular Cancer Redesign on rates of use of…
Risk Adjustment for Hospital Characteristics Reduces Unexplained Hospital Variation in Pressure Injury Risk
Research investigating risk factors for hospital-acquired pressure injury (HAPI) has primarily focused on the characteristics of patients and nursing staff.…
Comparative Trends in Heart Disease, Stroke, and All-Cause Mortality in the United States and a Large Integrated Healthcare Delivery System
Heart disease and stroke remain among the leading causes of death nationally. We examined whether differences in recent trends in…
Does Information about Members’ Social Determinants of Health Improve Prediction of Risk for Hospitalization, Emergency Department Visits, and Outpatient Utilization?
The new Kaiser Permanente Your Current Life Situation (YCLS) screening questionnaire will be mailed to a random sample of 7,000…
The Impact of Acute Organ Dysfunction on Long-Term Survival in Sepsis
To estimate the impact of each of six types of acute organ dysfunction (hepatic, renal, coagulation, neurologic, cardiac, and respiratory)…
Social and Functional Predictors of Rehospitalization: YCLS and PROMIS
This study aims to determine whether specific items from two questionnaires currently in use at Kaiser Permanente Northern California (the…
Characterizing and Predicting Adverse Drug Events Outside the Hospital
This study aims to employ machine learning methods to develop predictive models for adverse drug events, or ADEs, that result…
Mortality Measures to Profile Hospital Performance for Patients With Septic Shock
Sepsis care is becoming a more common target for hospital performance measurement, but few studies have evaluated the acceptability of…
Efficacy of Subthreshold Newborn Phototherapy During the Birth Hospitalization in Preventing Readmission for Phototherapy
Treatment of jaundiced newborns with subthreshold phototherapy (phototherapy given to newborns with bilirubin levels below those recommended in American Academy…
Healthcare Utilization and Infection in the Week Prior to Sepsis Hospitalization
To quantify healthcare utilization in the week preceding sepsis hospitalization to identify potential opportunities to improve the recognition and treatment…
Accuracy of international classification of diseases, ninth revision, codes for postpartum hemorrhage among women undergoing cesarean delivery
Determining the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) codes for postpartum hemorrhage (PPH) is vital…
How Fast is Fast Enough? Assessing Door-to-Needle Times and Outcomes of Stroke Patients Receiving Acute Thrombolysis Therapy Under the Kaiser Permanente Northern California Stroke EXPRESS Program
With stroke treatment, there is a general belief that "time is brain." However, there has been no published data examining…
Infant Hospitalizations and Mortality After Maternal Vaccination
The Advisory Committee on Immunization Practices currently recommends pregnant women receive influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular…
Contemporary Procedural Complications, Hospitalizations, and Emergency Visits After Catheter Ablation for Atrial Fibrillation
Contemporary data on complications and resource utilization after atrial fibrillation (AF) ablation are limited. We evaluated rates and risk factors…
Incorporating Longitudinal Comorbidity and Acute Physiology Data in Template Matching for Assessing Hospital Quality: An Exploratory Study in an Integrated Health Care Delivery System
We sought to build on the template-matching methodology by incorporating longitudinal comorbidities and acute physiology to audit hospital quality. Patients…
Flexible, Cluster-Based Analysis of the Electronic Medical Record of Sepsis with Composite Mixture Models
The widespread adoption of electronic medical records (EMRs) in healthcare has provided vast new amounts of data for statistical machine…
Recovery or Disability? Trajectories After Pneumonia: Integrating 12 Months of Frequent Patient-Reported Measures with EMR Data
This is a pilot study to determine the feasibility of conducting a prospective study that aims to characterize longitudinal trajectories…
Novel Telestroke Program Improves Thrombolysis for Acute Stroke Across 21 Hospitals of an Integrated Healthcare System
Faster treatment with intravenous alteplase in acute ischemic stroke is associated with better outcomes. Starting in 2015, Kaiser Permanente Northern…
Detecting Risk of Low Health Literacy in Disadvantaged Populations Using Area-based Measures.
Introduction: Socio-economic status (SES) and low health literacy (LHL) are closely correlated. Both are directly associated with clinical and behavioral…
Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System
Although healthcare organizations have decreased hospital-acquired pressure injury (HAPI) rates, HAPIs are not eliminated, driving further examination in both nursing…
Benefits of Intensive Care Unit Admission for Patients with Acute Respiratory Failure or Sepsis
Ideal and optimally efficient use of intensive care unit (ICU) resources would create benefits across the health care system. Ideal…
An Evaluation of the National Zero Suicide Model Across Learning Health Care Systems
This study seeks to develop metrics for evaluation of the Zero Suicide model across five integrated health care systems. These…
Short-Term Outcomes and Factors Associated With Adverse Events Among Adults Discharged From the Emergency Department After Treatment for Acute Heart Failure
Although 80% of patients with heart failure seen in the emergency department (ED) are admitted, less is known about short-term…
Predicting Readmission After Stroke Study (PRESS)
Hospital readmissions are a tremendous burden on patients, their families, and the health care system. In 2008, the Centers for…
Comparing Hospital Processes and Outcomes in California Medicare Beneficiaries: Simulation Prompts Reconsideration
This article is not a traditional research report. It describes how conducting a specific set of benchmarking analyses led us…
The Delivery Science Rapid Analysis Program: A Research and Operational Partnership at Kaiser Permanente Northern California
Health care researchers and delivery system leaders share a common mission to improve health care quality and outcomes. However, differing…
Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use
Hypoglycemia-related emergency department (ED) or hospital use among patients with type 2 diabetes (T2D) is clinically significant and possibly preventable.…
Identifying Distinct Subgroups of ICU Patients: A Machine Learning Approach
Identifying subgroups of ICU patients with similar clinical needs and trajectories may provide a framework for more efficient ICU care…
The Timing of Early Antibiotics and Hospital Mortality in Sepsis
Prior sepsis studies evaluating antibiotic timing have shown mixed results. To evaluate the association between antibiotic timing and mortality among…
Ibutilide Effectiveness and Safety in the Cardioversion of Atrial Fibrillation and Flutter in the Community Emergency Department
Little is known about the use of ibutilide for cardioversion in atrial fibrillation and flutter outside of clinical trials. We…
Prediction of Recurrent Clostridium Difficile Infection Using Comprehensive Electronic Medical Records in an Integrated Healthcare Delivery System
BACKGROUND Predicting recurrent Clostridium difficile infection (rCDI) remains difficult. We employed a retrospective cohort design. Granular electronic medical record (EMR)…
Adaptation of the Acute Organ Failure Score for Use in a Medicare Population
Without widely available physiologic data, a need exists for ICU risk adjustment methods that can be applied to administrative data.…
Individual and health system variation in rehospitalizations the year after pneumonia
Little is known about variation in patterns of recovery among patients discharged alive from hospitalizations for pneumonia.The aim of the…
Innovation and Technology: Electronic Intensive Care Unit Diaries
Hospitalization in the intensive care unit can be a stressful time for patients and their family members. Patients' family members…
Enhanced Recovery After Surgery Program Implementation in 2 Surgical Populations in an Integrated Health Care Delivery System
Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical…
Detection, Treatment and Follow-up of Unrecognized Behavioral Health Problems in the Emergency Department
Behavioral health (BH) problems frequently exacerbate medical conditions of emergency department (ED) patients and contribute to ongoing suboptimal healthcare utilization.…
Synch and Swim: Establishing Infrastructure for Collaborative Nursing Research in California
This project aims to lay the groundwork for collaborative nursing research effort involving both Kaiser Permanente California regions. Its initial…
Advance Alert Monitor Operations
The Systems Research Initiative will provide project management and operational consultation for the spread of the Advance Alert Monitor within…
Data-Driven Precision Medicine in Sepsis
Sepsis is a common and costly disease which contributes to nearly 1 in 2 hospital deaths in our healthcare system.…
CAREER: Managing Patient Flows with Congestion Effects
This project will employ simulation methods to analyze emergency department, hospital, and ICU data, including physiologic markers of severity of…
Innovative partnerships to advance public health training in community-based academic residency programs
Collaborative partnerships between community-based academic residency training programs and schools of public health, represent an innovative approach to training future…
Implementation of a multicenter performance improvement program for early detection and treatment of severe sepsis in general medical-surgical wards
Sepsis is a leading cause of in-hospital death, and evidence suggests a higher mortality in patients presenting with sepsis on…
Piloting electronic medical record-based early detection of inpatient deterioration in community hospitals
Patients who deteriorate in the hospital outside the intensive care unit (ICU) have higher mortality and morbidity than those admitted…
Early detection, prevention, and mitigation of critical illness outside intensive care settings
Patients who deteriorate outside the intensive care unit (ICU) are known to have elevated mortality and morbidity. Rapid response teams…
Data that drive: Closing the loop in the learning hospital system
The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture…
Early detection of critical illness outside the intensive care unit: Clarifying treatment plans and honoring goals of care using a supportive care team
Given the high mortality experienced by patients who deteriorate outside the intensive care unit, issues related to patient preferences around…
Can delivery systems use cost-effectiveness analysis to reduce healthcare costs and improve value?
Understanding costs and ensuring that we demonstrate value in healthcare is a foundational presumption as we transform the way we…
Identifying Spanish Language Competent Physicians: The Diabetes Study of Northern California (DISTANCE)
Language barriers negatively impact health care access and quality for US immigrants. Latinos are the second largest immigrant group and…
Development and Validation of an Electronic Medical Record-Based Alert Score for Detection of Inpatient Deterioration Outside the ICU
Patients in general medical-surgical wards who experience unplanned transfer to the intensive care unit (ICU) show evidence of physiologic derangement…
In-hospital mortality following treatment with red blood cell transfusion or inotropic therapy during early goal-directed therapy for septic shock: a retrospective propensity-adjusted analysis
We sought to investigate whether treatment of subnormal (
Big data in health care: using analytics to identify and manage high-risk and high-cost patients
The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data…
Rationale and Design of the Randomized Evaluation of Default Access to Palliative Services (REDAPS) Trial
The substantial nationwide investment in inpatient palliative care services stems from their great promise to improve patient-centered outcomes and reduce…
Association Among ICU Congestion, ICU Admission Decision, and Patient Outcomes
To employ automated bed data to examine whether ICU occupancy influences ICU admission decisions and patient outcomes. Retrospective study using…
A Comparison of Self-reported Medication Adherence to Concordance Between Part D Claims and Medication Possession.
OBJECTIVE: Medicare Part D claims indicate medication purchased, but people who are not fully adherent may extend prescription use beyond…
Mind the Gap: Hospitalizations from Multiple Sources in a Longitudinal Study.
BACKGROUND: Medicare claims and prospective studies with self-reported utilization are important sources of hospitalization data for epidemiologic and outcomes research.OBJECTIVES:…
Multicenter Implementation of a Treatment Bundle for Sepsis Patients with Intermediate Lactate Values
Treatments for patients with sepsis with intermediate lactate values (?2 and
Developing a framework for implementing intensive care unit diaries: a focused review of the literature
Intensive care unit diaries have been shown to improve post-critical illness recovery, however, prior reports of diary implementation are heterogeneous.…
Evaluation Following Staggered Implementation of the “Rethinking Critical Care” ICU Care Bundle in a Multicenter Community Setting
To evaluate process metrics and outcomes after implementation of the "Rethinking Critical Care" ICU care bundle in a community setting.…
Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
Septic shock currently refers to a state of acute circulatory failure associated with infection. Emerging biological insights and reported variation…
Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
The Third International Consensus Definitions Task Force defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to…
Variation in the Contents of Sepsis Bundles and Quality Measures: A Systematic Review
Sepsis contributes to one in every two to three inpatient hospital deaths. Early recognition and treatment are instrumental in reducing…
Nonelective Rehospitalizations and Postdischarge Mortality: Predictive Models Suitable for Use in Real Time
Hospital discharge planning has been hampered by the lack of predictive models. To develop predictive models for nonelective rehospitalization and…
Why the C-statistic is not informative to evaluate early warning scores and what metrics to use
Metrics typically used to report the performance of an early warning score (EWS), such as the area under the receiver…
Impact of Relative Contraindications to Home Management in Emergency Department Patients with Low-Risk Pulmonary Embolism
Studies of adults presenting to the emergency department (ED) with acute pulmonary embolism (PE) suggest that those who are low…
Pneumothorax is a rare complication of thoracic central venous catheterization in community EDs
The rate of iatrogenic pneumothorax associated with thoracic central venous catheterization in community emergency departments (EDs) is poorly described, although…
Infections Requiring Hospitalization as Predictors of Pediatric-Onset Crohn’s Disease and Ulcerative Colitis
Objectives. To assess the relationship between infections and the risk of pediatric-onset inflammatory bowel disease (IBD). Methods. We conducted a…
Lack of improved outcomes with increased use of targeted temperature management following out-of-hospital cardiac arrest: A multicenter retrospective cohort study
To assess whether increased use of targeted temperature management (TTM) within an integrated healthcare delivery system resulted in improved rates…
Trends in red blood cell transfusion and 30-day mortality among hospitalized patients
Blood conservation strategies have been shown to be effective in decreasing red blood cell (RBC) utilization in specific patient groups.…
Hospital readmission and healthcare utilization following sepsis in community settings
Sepsis, the most expensive cause of hospitalization in the United States, is associated with high morbidity and mortality. However, healthcare…
Increased one-year health care utilization in survivors of severe sepsis
Hospitalizations for severe sepsis are common, and a growing number of patients survive to hospital discharge. Nonetheless, little is known…
Hospital-Level Variation in Use of Cardiovascular Testing for Adults With Incident Heart Failure: Findings from the Cardiovascular Research Network Heart Failure Study
This study aimed to characterize the use of cardiovascular testing for patients with incident heart failure (HF) hospitalization who participated…
Accuracy of hospital standardized mortality rates: effects of model calibration
Risk-adjusted mortality rates are commonly used in quality report cards to compare hospital performance. The risk adjustment depends on models…
The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries.
Heart failure is a global pandemic affecting an estimated 26 million people worldwide and resulting in more than 1 million…
Predicting red blood cell transfusion in hospitalized patients: role of hemoglobin level, comorbidities, and illness severity
Randomized controlled trial evidence supports a restrictive strategy of red blood cell (RBC) transfusion, but significant variation in clinical transfusion…
Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants
The increased vulnerability of late preterm infants is no longer a novel concept in neonatology, with many studies documenting excess…
Automated identification of pneumonia in chest radiograph reports in critically ill patients
Prior studies demonstrate the suitability of natural language processing (NLP) for identifying pneumonia in chest radiograph (CXR) reports, however, few…
Risk-adjusting Hospital Mortality Using a Comprehensive Electronic Record in an Integrated Health Care Delivery System
OBJECTIVE: Using a comprehensive inpatient electronic medical record, we sought to develop a risk-adjustment methodology applicable to all hospitalized patients.…
Visitation policies and practices in United States intensive care units
Prior reports suggest that restrictive ICU visitation policies can negatively impact patients and their loved ones. However, visitation practices in…
Addition of time-dependent covariates to a survival model significantly improved predictions for daily risk of hospital death
RATIONAL, AIMS AND OBJECTIVES: The study aims to determine the extent to which the addition of post-admission information via time-dependent…
Intensification of diabetes medication and risk for 30-day readmission
AIM: To examine the association of in-hospital diabetes regimen intensification with subsequent 30-day risk for unplanned readmission/emergency department admission. METHODS:…
An electronic simplified acute physiology score-based risk adjustment score for critical illness in an integrated healthcare system*
OBJECTIVE: Risk adjustment is essential in evaluating the performance of an ICU; however, assigning scores is time-consuming. We sought to…
Risk factors for unplanned transfer to intensive care within 24 hours of admission from the emergency department in an integrated healthcare system
BACKGROUND: Emergency department (ED) ward admissions subsequently transferred to the intensive care unit (ICU) within 24 hours have higher mortality…
Adverse outcomes associated with delayed intensive care unit transfers in an integrated healthcare system
BACKGROUND: Patients with intensive care unit (ICU) transfers from hospital wards have higher mortality than those directly admitted from the…
The association between sepsis and potential medical injury among hospitalized patients
BACKGROUND: Patient safety remains a national priority, but the role of disease-specific characteristics in safety is not well characterized. METHODS:…
Total Serum Bilirubin Exceeding Exchange Transfusion Thresholds in the Setting of Universal Screening
OBJECTIVE: To describe the incidence and predictors of total serum bilirubin (TSB) levels that meet or exceed American Academy of…
Early detection of impending physiologic deterioration among patients who are not in intensive care: Development of predictive models using data from an automated electronic medical record
BACKGROUND: Ward patients who experience unplanned transfer to intensive care units have excess morbidity and mortality. OBJECTIVE: To develop a…
Derivation and validation of a model to predict daily risk of death in hospital
BACKGROUND: As electronic patient data from automated hospital databases become increasingly available, it is important to explore the ways in…
Urgent neurology consultation from the ED for transient ischemic attack
OBJECTIVE: The objective of this study was to evaluate the association between urgent neurology consultation and outcomes for patients with…
Interpreting conjugated bilirubin levels in newborns
OBJECTIVE: To examine the clinical significance of elevated conjugated bilirubin (CB) levels in newborns. STUDY DESIGN: This retrospective study evaluated…
Variation in diagnosis of apnea in moderately preterm infants predicts length of stay
OBJECTIVE: Apnea of prematurity is one of the most common diagnoses in the NICU. Because resolution of apnea is a…
Respiratory syncytial virus testing during bronchiolitis episodes of care in an integrated health care delivery system: a retrospective cohort study
BACKGROUND: Bronchiolitis has the highest incidence rate of any lower respiratory infection among infants and children /=41 weeks' GA. Bronchiolitis…
Length of stay and imminent discharge probability distributions from multistage models: variation by diagnosis, severity of illness, and hospital
Multistage models have been effective at describing length of stay (LOS) distributions for diverse patient groups. Our study objective was…
Length of stay predictions: improvements through the use of automated laboratory and comorbidity variables
BACKGROUND: Length of stay (LOS) is a common measure of hospital resource utilization. Most methods for risk-adjusting LOS are limited…
Effect of choice of estimation method on inter-hospital mortality rate comparisons
OBJECTIVE: To evaluate and compare the use of 6 different methods for calculating expected mortality rates and standardized mortality ratios…
Intra-hospital transfers to a higher level of care: contribution to total hospital and intensive care unit (ICU) mortality and length of stay (LOS)
BACKGROUND: Patients who experience intra-hospital transfers to a higher level of care (eg, ward to intensive care unit [ICU]) are…
The role of outpatient facilities in explaining variations in risk-adjusted readmission rates between hospitals
OBJECTIVE: Validate risk-adjusted readmission rates as a measure of inpatient quality of care after accounting for outpatient facilities, using premature…
Patient-to-nurse ratios and outcomes of moderately preterm infants
OBJECTIVE: Moderately preterm infants (30-34(6/7) weeks' gestational age) represent the largest population of NICU residents. Whether their clinical outcomes are…
The Kaiser Permanente inpatient risk adjustment methodology was valid in an external patient population
OBJECTIVES: Accurately predicting hospital mortality is necessary to measure and compare patient care. External validation of predictive models is required…
Numbers needed to treat with phototherapy according to American Academy of Pediatrics guidelines
OBJECTIVES: Our aims were to estimate the efficacy of hospital phototherapy for neonatal jaundice and the number needed to treat…
Infant functional status: the timing of physiologic maturation of premature infants
OBJECTIVE: To describe the maturation of physiologic milestones in preterm infants born between 24 and 32 weeks' gestational age. METHODS:…
Time to send the preemie home? Additional maturity at discharge and subsequent health care costs and outcomes
OBJECTIVE: To determine whether longer stays of premature infants allowing for increased physical maturity result in subsequent postdischarge cost savings…
Factors influencing parental satisfaction with neonatal intensive care among the families of moderately premature infants
OBJECTIVE: The goal was to examine the factors influencing parental satisfaction with neonatal intensive care for moderately premature infants in…
Risk factors for developing apnea after immunization in the neonatal intensive care unit
OBJECTIVES: Among hospitalized NICU infants, preimmunization apnea is a well-recognized predictor of postimmunization apnea. However, predictors for postimmunization apnea among…
Risk-adjusting hospital inpatient mortality using automated inpatient, outpatient, and laboratory databases
OBJECTIVES: To develop a risk-adjustment methodology that maximizes the use of automated physiology and diagnosis data from the time period…
Case-control study of antibiotic use and subsequent Clostridium difficile-associated diarrhea in hospitalized patients
OBJECTIVE: To determine which antibiotics increase or decrease the risk of Clostridium difficile-associated diarrhea (CDAD). DESIGN: Retrospective case-control study. SETTING:…
Five-year neurodevelopmental outcome of neonatal dehydration
OBJECTIVE: To determine the long-term outcome of neonatal dehydration. STUDY DESIGN: We identified 182 newborns who were rehospitalized with dehydration…
Neonatal intensive care unit census influences discharge of moderately preterm infants
OBJECTIVE: The timely discharge of moderately premature infants has important economic implications. The decision to discharge should occur independent of…
Progress in pediatric asthma surveillance I: the application of health care use data in Alameda County, California
INTRODUCTION: The ability to conduct community-level asthma surveillance is increasingly crucial for public health programming and child health advocacy. We…
Unstudied infants: outcomes of moderately premature infants in the neonatal intensive care unit
BACKGROUND: Newborns of 30-34 weeks gestation comprise 3.9% of all live births in the United States and 32% of all…
Outcomes among newborns with total serum bilirubin levels of 25 mg per deciliter or more
BACKGROUND: The neurodevelopmental risks associated with high total serum bilirubin levels in newborns are not well defined. METHODS: We identified…
Place of birth and variations in management of late preterm (‘near-term’) infants
BACKGROUND: The purpose of this study is to characterize variations in management late preterm infants because such variations in such…
Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions
BACKGROUND: Newborns who are 35 to 36 weeks gestation comprise 7.0% of all live births and 58.3% of all premature…
Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom
OBJECTIVE: To compare gestational age at discharge between infants born at 30-34(+6) weeks gestational age who were admitted to neonatal…
Hospital-level rates of fluoroquinolone use and the risk of hospital-acquired infection with ciprofloxacin-nonsusceptible Pseudomonas aeruginosa
BACKGROUND: In recent years, Pseudomonas aeruginosa has become increasingly resistant to fluoroquinolones, and fluoroquinolone use in the United States has…
What have we learned from observational studies on neonatal sepsis?
OBJECTIVE: To assess how observational studies on neonatal sepsis can help define the knowledge base required for neonatal randomized, clinical…
Trends in severe bronchopulmonary dysplasia rates between 1994 and 2002
OBJECTIVE: To examine temporal trends in the rates of severe bronchopulmonary dysplasia (BPD) between 1994 and 2002. STUDY DESIGN: In…
Rehospitalisation after birth hospitalisation: patterns among infants of all gestations
AIM: To analyse rehospitalisation of newborns of all gestations. METHODS: A total of 33,276 surviving infants of all gestations born…
Looking for Trouble in All the Right Places: The Legal Implications Associated with ‘Electronic Signatures’ and High-risk Clinical Situations
Background: Voluntary reporting systems identify only a fraction of medical errors. Electronic identification mechanisms, which are more efficient, have been…
Rehospitalization in the first year of life among infants with bronchopulmonary dysplasia
OBJECTIVE: To describe rates and identify risk factors for rehospitalization during the first year of life among infants with bronchopulmonary…
Infants with bilirubin levels of 30 mg/dL or more in a large managed care organization
OBJECTIVE: To describe the incidence, etiology, treatment, and outcome of newborns with total serum bilirubin (TSB) levels >or=30 mg/dL (513…
Pelvic organ prolapse surgery in the United States, 1997
OBJECTIVE: Our purpose was to describe the prevalence, regional rates and demographic characteristics, morbidity, and mortality of pelvic organ prolapse…
A critical review of cost reduction in neonatal intensive care. II. Strategies for reduction
Neonatal intensive care is extremely expensive; there is both a financial and an ethical obligation to practice efficiently. In the…
Rehospitalization for respiratory syncytial virus among premature infants
OBJECTIVES: New interventions to prevent respiratory syncytial virus (RSV) have recently become available. Clinical decisions about the use of these…
Effects of providing hospital-based doulas in health maintenance organization hospitals
OBJECTIVE: To evaluate whether providing doulas during hospital-based labor affects mode of delivery, epidural use, breast-feeding, and postpartum perceptions of…
Developmentally supportive care in a neonatal intensive care unit: a research utilization project
PURPOSE: To implement three aspects of developmental care: lower noise levels, decreased light levels, and flexed, midline positioning. DESIGN: Research…
