The study, which will be published in Thursday's New England Journal of Medicine, found that extremely premature babies were up to twice as likely to survive when treated at a busy, advanced-care center rather than one of the many community hospitals that have opened ICUs in recent years.
The more the hospitals handled such babies, the more chances it has of the best survival records. AP quotes Ciaran Phibbs, lead author of the study and a Stanford University health economist, as saying, "Size really matters."
Researchers reviewed nearly 48,000 premature births and fetal deaths in California from 1991 through 2000 and focused on babies with very low birth weights of 1 to 3 pounds.
The best survival rates were found to be that of California's top neonatal intensive care units, called Level 3 NICUs, which had the full range of neonatal care and surgery. It was also found that those hospitals that treated more than 100 premature babies each year had the lowest death rate, about 18 percent.
The study also found that in similar facilities that treated 50 to 100 infants a year, about 20 percent died, especially in the lesser equipped neonatal units. The hospital that has the lowest level of care and the smaller the number of babies saw the highest level of a death rate. In Level 2 NICUs that saw 10 or fewer tiny babies a year, more than 31 percent died.
The reason why the bigger and busier hospitals have better survival rates was attributed to advanced obstetrics care, including around-the-clock anesthesiology and other services to quickly handle emergencies.
