METHODS: We used discharge data from all 26 Wyoming hospitals during fiscal years 2009–2014. We used International Classification of Diseases, Ninth Revision codes to identify neonates with birth-associated complications among hospital-born neonates; complications included respiratory and neurologic conditions, birth trauma, shock, and death. We calculated statewide and facility-specific morbidity rates (percentage of neonates with ≥1 complication among total hospital-born neonates) and determined how high-risk deliveries (Cesarean sections and twin deliveries) and hospital charges were related to morbidity rates. Statistical differences were assessed using chi-square and Mann-Whitney U tests.
RESULTS: The statewide neonatal morbidity rate was 10.4% (3,880 neonates with ≥1 complication among 37,434 hospital-born neonates). Facility-specific morbidity rates varied (range: 0%–17.6%). The most frequent complications were respiratory (55% of morbidities). Morbidity rates were higher among high-risk deliveries; neonates delivered by Cesarean section had a higher morbidity rate than neonates delivered vaginally (16.4% versus 7.9%, P <.001), and twins had a higher morbidity rate than singletons (36.4% versus 9.8%, P <.001). Hospitals charged a mean of $8,501 (range: $0–$115,662) per morbidity-associated neonatal hospitalization, compared with $2,605 (range: $21–$9,992) per hospitalization without morbidity (P <.001).
CONCLUSIONS: This composite measure provides statewide and hospital-specific neonatal morbidity rates and demonstrates expected differences in morbidity rates and hospital charges, making it a useful surveillance tool in Wyoming.