Abstract
Purpose
This study aimed to examine variation in genetic testing between neonatal intensive
care units (NICUs) across hospitals over time.
Methods
We performed a multicenter large-scale retrospective cohort study using NICU discharge
data from the Pediatric Hospital Information System database between 2016 and 2021.
We analyzed the variation in the percentage of NICU patients who had any genetic testing
across hospitals and over time. We used a multivariable multilevel logistic regression
model to investigate the potential association between patient characteristics and
genetic testing.
Results
The final analysis included 207,228 neonates from 38 hospitals. Overall, 13% of patients
had at least 1 genetic test sent, although this varied from 4% to 50% across hospitals.
Over the study period, the proportion of patients tested increased, with the increase
disproportionately borne by hospitals already testing high proportions of patients.
On average, patients who received genetic testing had higher illness severity. Controlling
for severity, however, only minimally reduced the degree of hospital-level variation
in genetic testing.
Conclusion
The percentage of NICU patients who undergo genetic testing varies among hospitals
and increasingly so over time. Variation is largely unexplained by differences in
severity between hospitals. The degree of variation suggests that clearer guidelines
for NICU genetic testing are warranted.
Keywords
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Article info
Publication history
Published online: December 12, 2022
Accepted:
December 8,
2022
Received in revised form:
December 7,
2022
Received:
September 27,
2022
Identification
Copyright
© 2022 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.
