Alpha 2.0
Login Register
» Articles » PMID: 29622778

Disparities in NICU Quality of Care: a Qualitative Study of Family and Clinician Accounts

Overview
Journal J Perinatol
Specialty Gynecology & Obstetrics
Date 2018 Apr 7
PMID 29622778
Citations 42
Authors
Krista Sigurdson
Christine Morton
Briana Mitchell
Jochen Profit
Affiliations
Soon will be listed here.
Abstract

Objective: To identify how family advocates and clinicians describe disparities in NICU quality of care in narrative accounts.

Study Design: Qualitative analysis of a survey requesting disparity stories at the 2016 VON Quality Congress. Accounts (324) were from a sample of RNs (n = 114, 35%), MDs (n = 109, 34%), NNPs (n = 55, 17%), RN other (n = 4, 1%), clinical other (n = 25, 7%), family advocates (n = 16, 5%), and unspecified (n = 1, <1%).

Results: Accounts (324) addressed non-exclusive disparities: 151 (47%) language; 97 (30%) culture or ethnicity; 72 (22%) race; 41 (13%) SES; 28 (8%) drug use; 18 (5%) immigration status or nationality; 16 (4%) sexual orientation or family status; 14 (4%) gender; 10 (3%) disability. We identified three types of disparate care: neglectful care 85 (26%), judgmental care 85 (26%), or systemic barriers to care 139 (44%).

Conclusions: Nearly all accounts described differential care toward families, suggesting the lack of equitable family-centered care.

Citing Articles

Voices of parents of children with major congenital anomalies admitted to the NICU: initial diagnosis, hospitalization, and discharge home.

Lyon J, McAndrew N, Geich A, AbuZahra T, Leuthner S, Lagatta J J Perinatol. 2025; .

PMID: 40038541 DOI: 10.1038/s41372-025-02255-8.

Experiences of communication in the neonatal intensive care unit for mothers with a preferred language other than English.

Kalluri N, Witt R, Kubicka Z, Parker M, Cordova-Ramos E J Perinatol. 2025; .

PMID: 39979432 DOI: 10.1038/s41372-025-02229-w.

Receipt of Federal Income Support by Eligible Low-Birth-Weight Infants.

Guo M, Martin M, Kavanagh N, Chen J, Hemmeter J, Kawachi I JAMA Pediatr. 2025; .

PMID: 39960725 PMC: 11833659. DOI: 10.1001/jamapediatrics.2024.6262.

" " Exploring the Experiences of Black and Hispanic Parents following a Congenital Heart Disease Diagnosis.

Rent S, Poon K, Sooy-Mossey M, Weeks M, Roberts J, Douglas D AJP Rep. 2025; 15(1):e6-e17.

PMID: 39780940 PMC: 11706635. DOI: 10.1055/a-2504-1813.

Investigation of mothers' elicited infant-directed speech and singing for preterm infants.

Kjeldsen C, Neel M, Jeanvoine A, Maitre N Pediatr Res. 2024; .

PMID: 39415040 DOI: 10.1038/s41390-024-03618-1.

References
1.
Howell E . Racial disparities in infant mortality: a quality of care perspective. Mt Sinai J Med. 2008; 75(1):31-5. DOI: 10.1002/msj.20018. View
2.
Profit J, Zupancic J, Gould J, Pietz K, Kowalkowski M, Draper D . Correlation of neonatal intensive care unit performance across multiple measures of quality of care. JAMA Pediatr. 2013; 167(1):47-54. PMC: 4028032. DOI: 10.1001/jamapediatrics.2013.418. View
3.
Profit J, Gould J, Bennett M, Goldstein B, Draper D, Phibbs C . Racial/Ethnic Disparity in NICU Quality of Care Delivery. Pediatrics. 2017; 140(3). PMC: 5574732. DOI: 10.1542/peds.2017-0918. View
4.
Roberts D . Debating the cause of health disparities -- implications for bioethics and racial equality. Camb Q Healthc Ethics. 2012; 21(3):332-41. DOI: 10.1017/S0963180112000059. View
5.
Morales L, Staiger D, Horbar J, Carpenter J, Kenny M, Geppert J . Mortality among very low-birthweight infants in hospitals serving minority populations. Am J Public Health. 2005; 95(12):2206-12. PMC: 1449508. DOI: 10.2105/AJPH.2004.046730. View