Expanding NICUs: Is More Care Always Better?

Between 2005 and 2019, the number of neonatal intensive care units (NICUs) in the U. S. grew by 10%, with NICU beds increasing by 30%. While this expansion aims to provide better care, it also raises concerns about unnecessary intensive care admissions. Research shows that when a new NICU opens in a county, the number of newborns admitted to these units jumps by 8%. Surprisingly, most of these new admissions are healthier newborns weighing over 2, 500 grams, not the very premature ones weighing less than 1, 500 grams.

For the smallest and most vulnerable infants, an increase in NICU supply only becomes a lifesaver in areas with limited access. In these places, more NICUs reduce mortality rates for very small newborns. However, the flip side is that this increase in NICU supply also means healthier babies are getting admitted more often. This highlights a trade-off: more NICUs save the most vulnerable babies but also see more admissions of healthier ones.

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