Date of Conferral

2-17-2026

Degree

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

School

Health Sciences

Advisor

Cheryl Cullen

Abstract

Neonatal readmissions remain a significant challenge in urban acute care hospitals serving indigent preterm infants. These readmissions impose substantial financial burdens, with high-cost conditions such as bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity driving recurring expenditures. This integrative review examined strategies that healthcare administrators can implement to reduce neonatal readmissions, improve care equity, and optimize healthcare spending in hospitals serving vulnerable populations in the Commonwealth of Virginia. A comprehensive literature search of empirical and non-empirical studies yielded 105 results for quality assessment using the Johns Hopkins appraisal tools. A total of 29 were included for thematic analysis. Five main themes with eight sub-themes emerged; strengthen leadership and systems through collaborative leadership and data-driven technology use; build a skilled, inclusive, and safety-oriented workforce; integrate care and address social determinants of health; advance health policy and access through Medicaid expansion and advocacy; and use data and resources to promote sustainable outcomes through benchmarking and efficient resource alignment. Healthcare systems should invest in advanced technologies, cultivate a culturally competent and safety-focused workforce, leverage data analytics, establish multidisciplinary post-discharge programs, and expand insurance coverage. Evidence consistently demonstrates that aligning organizational improvements with social determinants of health strengthens infant health, supports families, and advances community equity which can promote meaningful social change.

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