Does the Use of New Technology By Care Managers Have an Impact on Neonatal Intensive Care Unit (NICU) Admissions and Length of Stay?

OBJECTIVES: Neonatal intensive care units (NICU) provide essential medical care to neonates; however, they are associated with hospital-acquired infections, less maternal-newborn bonding, and high costs. Implementing strategies to lower NICU admission rates and shorten NICU length of stay (LOS) is essential. This study uses causal-inference methods to evaluate the impact of care managers using new technology to identify and risk stratify pregnancies on NICU admissions and NICU LOS.

METHODS: We utilize claims data of pregnant women from the CareFirst BlueCross BlueShield Community Health Plan District of Columbia from 2013 to 2022 which includes the pre-intervention period before the use of new technology by care managers and the post-intervention period with the use of new technology by care managers. Our sample has 6,295 delivery claims from neonates who were matched with maternal data and 7,932 delivery claims from neonatal only data. To evaluate the impact of the technological intervention we used both Generalized Linear Models (GLM) as well as Bayesian Structural Time-Series (BSTS) models.

RESULTS: Our findings from the GLM models suggest an overall average reduction in the odds NICU Admission from 24%-32% and an average decrease in NICU LOS from 8.3%-57%. Using BSTS models we estimate counterfactuals for NICU admissions and NICU LOS, which suggest an average reduction in 72 NICU admissions and 516 NICU days per year.

CONCLUSIONS:

Overall, our results show that equipping care managers with better technological tools can lead to significant improvements in neonatal health outcomes as indicated by a reduction in NICU admissions and NICU LOS.