Trends in Neonatal Intensive Care Unit Utilization in a Large Integrated Health Care System

Key Points Question How are neonatal intensive care unit (NICU) admission rates and NICU patient-days changing over time for various birth weight, gestational age, and acuity subgroups? Findings In this cohort study of neonates in a large integrated health care system, the risk-adjusted NICU admission rate and NICU patient-days decreased from 2010 through 2018 without an increase in readmission or mortality rates. The decrease was associated with the high gestational age and birth weight subgroup. Meaning These findings suggest that substantial decreases in NICU utilization across large birth populations are possible, and the remaining unexplained variation suggests that further changes are also possible.