This study investigated whether the proportion of black very low-birth-weight (VLBW) infants treated by hospitals is associated with neonatal mortality for black and white VLBW infants. The authors analyzed medical records linked to secondary data sources for 74,050 black and white VLBW infants (501 g to 1500 g) treated by 332 hospitals participating in the Vermont Oxford Network from 1995 to 2000. Hospitals where more than 35 percent of VLBW infants treated were black were defined as "minority-serving."
Compared with hospitals where less than 15 percent of the VLBW infants were black, minority-serving hospitals had significantly higher risk-adjusted neonatal mortality rates (White infants: odds ratio [OR]=1.30, 95% confidence interval [CI] = 1.09, 1.56; Black infants: OR = 1.29, 95% CI = 1.01, 1.64; Pooled: OR = 1.28, 95% CI=1.10, 1.50). Higher neonatal mortality in minority-serving hospitals was not explained by either hospital or treatment variables.
The authors conclude that minority-serving hospitals may provide lower quality of care to VLBW infants compared with other hospitals. Because VLBW black infants are disproportionately treated by minority-serving hospitals, higher neonatal mortality rates at these hospitals may contribute to racial disparities in infant mortality in the U.S.