Neonatal Intensive Care Outcomes in the Military Health System: Comparison of Military and Civilian Hospital Births

作者：Thornton Mu, Celeste J. Romano, Clinton Hall, Gia R. Gumbs, Ava Marie S. Conlin, Rasheda J. Vereen, JoAnna K. Leyenaar, David C. Goodman · 发表于：Military Medicine · 年份：2025 · DOI：10.1093/milmed/usaf043 · 被引用次数：3 · 研究领域：Occupational Health and Performance、Trauma, Hemostasis, Coagulopathy, Resuscitation、Infant Development and Preterm Care

INTRODUCTION: Military Health System (MHS)-insured newborns receive care in military and civilian hospitals. Differences in delivery location and corresponding payment schemas raise questions regarding possible health system effects on utilization and outcomes. We hypothesize that newborn utilization and clinical outcomes differ between military and civilian hospitals and that the differences may be more pronounced among lower risk newborns (i.e., late preterm and non-preterm infants). MATERIAL AND METHODS: The newborn cohort comprised live births captured in DoD Birth and Infant Health Research program data from October 2015 through December 2020. Population characteristics, hospital measures, and newborn clinical outcomes were examined using administrative medical data. Descriptive statistics for birth hospitalization and post-discharge events were calculated by the birth hospital (military or civilian) and gestational age cohort (very preterm, 23-31 weeks; moderate preterm, 32-33 weeks; late preterm, 34-36 weeks; and non-preterm ≥37 weeks). Risk-adjusted Poisson regression models compared select birth hospitalization events by birth hospital type, accounting for differences in the newborn population with regard to predicted mortality and diagnoses/procedures associated with the use of special care. Adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) were stratified by gestational age cohort. RESULTS: Overall, 470,175 singleton live births were included, and the ...