Neonatal Intensive Care Outcomes in the Military Health System: Comparison of Military and Civilian Hospital Births.

This article examines differences in newborn clinical utilization and outcomes between military and civilian hospitals for infants insured by the U.S. Military Health System (MHS). Analyzing 470,175 singleton live births from 2015 to 2020, the study found that late preterm (34–36 weeks) and non-preterm (≥37 weeks) infants born in civilian hospitals had longer birth hospital stays, more special care days, and higher neonatal intensive care unit (NICU) admission rates compared to those born in military hospitals, after adjusting for risk factors. Conversely, military hospital births showed lower documented use of ancillary imaging but higher rates of hospital admissions and emergency room visits within 30 and 90 days post-discharge across all gestational age groups. These findings highlight potential differences in care practices and resource utilization between military and civilian settings, offering important considerations for MHS leadership regarding the balance of direct military care versus purchased civilian care for newborns.