Analysis of variability in neonatal care units: A retrospective analysis

The number of babies needing neonatal care is increasing due mainly to technological and therapeutic advances. These advances have implied a decreasing neonatal mortality rate for low birth weight infants and also a falling incidence of preterm stillbirth. Unfortunately, the neonatal system is facing some challenges, such as the nurse shortage and the lack of cots that could impact neonates´ length-of-stay (LOS), medical conditions, and so on. In this paper, we aim at studying the variability of the neonatal system and its population. We first analyse the length of stay, gestation age and birth weight of babies admitted to an English neonatal hospital. We then perform an analysis of variation of the LOS for each level of care based on variables specific to babies´ pathways, i.e. reasons for admission, types of referral, discharge destinations and booked places. Finally, we estimate the pairwise correlations between intensive care unit LOS, high dependency unit LOS and special care unit LOS. Hence, understanding babies characteristics and how long they will stay at each level of care is an important step for an efficient management of the neonatal system.