Providence Health & Services

The Value and Benefit Metric Estimator is a risk adjusted, composite tool designed for use in very low birth weight (VLBW) infants. These two metrics quantify the 8 major NICU morbidities with appropriate risk adjustment, and account for the principal indicator of hospital resource utilization. These measurements are based upon a NICU's own yearly outcomes data. The purpose of these metrics is to provide an inclusive, objective, numeric summary of a NICU's proficiency caring for VLBW infants. Using these two measurement tools can help a NICU's professional staff assess the effectiveness of their clinical practices, quality improvement efforts, and overall leadership and productive culture.

The Value and Benefit Metric Estimator website is maintained by the Providence St. Vincent Medical Center NICU (Providence Health & Services, Portland, OR).

The Metric

Value = Benefit / Cost multiplied by Risk Adjusters

Benefit = Rate of the 8 major morbidities in Very Low Birth Weight Infants, risk adjusted, summed, and weighted equally - Chronic Lung Disease, Grade 3-4 Intraventricular Hemorrhage, Periventricular Leukomalacia, Stage 3-4 Retinopathy of Prematurity, Necrotizing Enterocolitis, Gastrointestinal Perforation, Any Late Infection, and Discharge Weight < 10th percentile

Cost = Total Hospital Length of Stay in Survivors (mean, days)

NICU Risk Adjusters

  • Gestational Age
  • Birth Weight (Small for Gestational Age)
  • Inborn/Outborn
  • Major Birth Defects
  • Multiple Birth
  • Mode of Delivery (cesarean section)
  • Gender
  • Apgar Score 1 minute
  • Mortality Excluding Early Deaths (<12 hours)