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Shining a Bright Light on the Care of Sick Babies

A grant from the Anthem Foundation will fund the first comprehensive, nationwide study of neonatal intensive care.

A three-year, $800,000 grant from the Anthem Foundation to The Dartmouth Institute for Health Policy & Clinical Practice (TDI) will fund the first large-scale effort to bring transparency to the care of sick newborn babies. In the past 30 years, neonatal intensive care has been highly successful in reducing death and disability among infants who are born critically ill or premature. As a result, neonatal intensive care units (NICUs) have grown tremendously in size and number in the U.S., while the number of newborns has remained about the same.

Dr. David Goodman,  Professor of Pediatrics at the Geisel School of Medicine and TDI, and the Dartmouth Atlas co-principal investigator.
Dr. David Goodman, Professor of Pediatrics at the Geisel School of Medicine and TDI, and the Dartmouth Atlas co-principal investigator.

“Very few published reports have examined the quality and efficiency of medical care across the full range of newborns and care settings” says David Goodman, MD, MS, Professor of Pediatrics at Dartmouth’s Geisel School of Medicine and of TDI. “This study will provide the first national description of the care of newborns, including those who are very ill and those with less severe problems.”

Goodman will lead the project, which will include the creation of the first-ever Dartmouth Atlas of Health Care of Neonatal Intensive Care. The Dartmouth Atlas, based at TDI, is known internationally for its detailed reports examining the cost, quality, and efficiency of health care and how care varies from region to region and between medical centers.

“Breathtaking advances in science and medical technology coupled with highly specialized professional training have been brought together in the neonatal ICU to provide ill babies with the most comprehensive state-of-the-art care known in modern medicine,” said Sam Nussbaum, MD, chief medical officer for Anthem, Inc. “The results of the Dartmouth Institute’s research will increase our understanding of the fundamental reasons for NICU hospitalization, impact the way specialized NICU care is delivered across the country to our nation’s newborns and provide these babies a healthier start of life. We are very excited to work with Drs. David Goodman and George Little and their colleagues at Dartmouth to help fund and provide information for studies that will make a difference for our nation’s newborns and their families.  This is one example of the many commitments Anthem has made to improve access and quality of care to mothers and their children.”

This study is possible, in part, because of TDI’s 30-plus years of experience analyzing large health-care datasets. Using data from commercial health insurance companies and the Centers for Medicare and Medicaid Services, the project will answer questions such as: How do cost, quality, and practice patterns of newborn care differ among regions of the country?

The resulting report and journal articles will be made publicly available and disseminated to key stakeholders, including providers, policymakers, and perinatal policy groups.

Collaborating with Goodman on the project is George Little, MD, Professor of Pediatrics and of Obstetrics at Geisel, an international expert in perinatal care and policy, and a long-time neonatologist with the Dartmouth-Hitchcock health system. While this research will provide data that families can use to make well-informed choices about where to receive care, there often is not time for such analysis, Little points out.

“Furthermore, complications during pregnancy and labor can occur unexpectedly and are highly stressful,” says Little. “By mapping the quality, variations, and outcomes of neonatal intensive care region by region, we will be providing health care systems the information they need to identify best practices and improve their own quality, thereby improving neonatal intensive care across the nation.”


About the Dartmouth Institute

The Dartmouth Institute for Health Policy & Clinical Practice was founded in 1988 by Dr. John E. Wennberg as the Center for the Evaluative Clinical Sciences (CECS). Among its 25 years of accomplishments, it has established a new discipline and educational focus in the Evaluative Clinical Sciences, introduced and advanced the concept of shared decision-making for patients, demonstrated unwarranted variation in the practice and outcomes of medical treatment, developed the first comprehensive examination of US health care variations (The Dartmouth Atlas), and has shown that more health care is not necessarily better care.


About the Geisel School of Medicine at Dartmouth

Founded in 1797, the Geisel School of Medicine at Dartmouth strives to improve the lives of the communities it serves through excellence in learning, discovery, and healing. The Geisel School of Medicine is renowned for its leadership in medical education, health care policy and delivery science, biomedical research, global health, and in creating innovations that improve lives worldwide. As one of America’s leading medical schools, Dartmouth’s Geisel School of Medicine is committed to training new generations of diverse leaders who will help solve our most vexing challenges in health care.


About Anthem Foundation

The Anthem Foundation is the philanthropic arm of Anthem, Inc. and through charitable contributions and programs, the Foundation promotes the inherent commitment of Anthem, Inc. to enhance the health and well-being of individuals and families in communities that Anthem, Inc. and its affiliated health plans serve. The Foundation focuses its funding on strategic initiatives that address and provide innovative solutions to health care challenges, as well as promoting the Healthy Generations Program, a multi-generational initiative that targets specific disease states and medical conditions. These disease states and medical conditions include: prenatal care in the first trimester, low birth weight babies, cardiac morbidity rates, long term activities that decrease obesity and increase physical activity, diabetes prevalence in adult populations, adult pneumococcal and influenza vaccinations and smoking cessation. The Foundation also coordinates the company’s year-round Associate Giving program which provides a 50 percent match of associates’ pledges, as well as its Volunteer Time Off and Dollars for Doers community service programs. To learn more about the Anthem Foundation, please visit http://www.anthem.foundation and its blog at http://anthemfoundation.tumblr.com.