Date of Conferral

8-1-2024

Date of Award

8-1-2024

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Cheryl Cullen

Abstract

Substance use, including opioids, during pregnancy may lead to the birth of infants with neonatal abstinence syndrome (NAS). With billions of dollars in annual costs to the U.S. health care system for resource use and hospital length of stay (LOS), federal and state authorities have made improving care and reducing the financial burden of substance use disorders and ramifications of opioid dependence a priority and have incentivized hospitals to improve care delivery and outcomes for this population. The purpose of this quantitative study was to examine the relationship between hospital participation in a performance excellence framework and LOS for substance-exposed infants diagnosed with NAS in the U.S. state of New Jersey. The independent variable was Magnet accreditation status, and the dependent variable was LOS. Covariates included patient gestational age at birth and hospital characteristics. The Donabedian model of structure, process, and outcome for assessing the quality of health care delivery served as the theoretical foundation of this study. Secondary data were acquired from the Healthcare Cost and Utilization Project’s 2021 New Jersey State Inpatient Database. Results indicated that Magnet hospitals had a lower median LOS; however, Magnet status did not have a statistically significant relationship with LOS (p = .121). There was a statistically significance association with gestational age (p = .007). Hospital size (p = .178), teaching status (p = .167) and hospital location (p = .258) were not statistically significant. The study may promote positive social change by informing hospital administrators of NAS patient outcomes and by illustrating the potential value of Magnet accreditation and financial performance in value-based programs.

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