# Quantification of neonatal transport networks through network analysis: a new approach to studying neonatal regionalization

> **NIH AHRQ K08** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2021 · $150,933

## Abstract

PROJECT SUMMARY/ABSTRACT
Sarah N. Kunz, MD, MPH is a neonatologist at Beth Israel Deaconess Medical Center (BIDMC) and an
Instructor of Pediatrics at Harvard Medical School (HMS). Dr. Kunz's research and career plans focus on
developing novel and quantitative ways of defining and studying neonatal referral networks and ultimately
optimizing these systems to improve quality of care. Outcomes for very low birth weight (VLBW; <1500 grams)
babies are highly variable across the United States, arising in part from differential implementation of
regionalization, which prioritizes targeting high-risk births at hospitals that can provide adequate care. When
VLBW infants are born at hospitals without advanced neonatal intensive care, they require transport to a
higher-level center, increasing their risk of death and disability. Current tools to measure transport quality are
limited to easily measurable characteristics such as transport distance and team composition. More
sophisticated methods are required to understand how unmeasured aspects of neonatal transport influence
outcomes: specifically, how transports function in the context of the larger hospital referral network and how
the strength of hospital relationships affects outcomes. In this application, Dr. Kunz proposes applying network
science methods to linked clinical and transport datasets to analyze the VLBW transport network in California,
with particular attention to the effect of transport quality and network characteristics on outcomes. The specific
aims of this study are to: (1) characterize and quantify acute neonatal VLBW referral networks and transport
characteristics; (2) empirically define “cohesion” of VLBW infant transport networks; (3) test the association
between network cohesion and transport quality and outcomes; and (4) optimize transport networks. To
achieve these aims and further her long-term career goal of becoming an independent health services
researcher focused on improving care delivery systems, Dr. Kunz has constructed a career development plan
combining intensive mentorship, hands-on research experience, and didactic coursework. The oversight of her
expert mentors, along with courses in network analysis, advanced statistical methods, health policy, and
organizational culture, will build on the strong foundation she gained from her fellowship in health services
research and her Master of Public Health. Her institutional environment bridges two strong academic settings
(BIDMC/HMS and the California Perinatal Quality Care Collaborative/Stanford University). Upon completion,
the proposed research will elucidate the contribution of patient-, hospital-, transport-, and network-level
characteristics to the functioning of neonatal referral systems, and identify concrete approaches for systems-
level improvement, methods that will be applicable to other types of patient referral systems. Undertaking the
proposed project and career development activities are essential for Dr. Ku...

## Key facts

- **NIH application ID:** 10148803
- **Project number:** 5K08HS025749-04
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Sarah Nicole Kunz
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $150,933
- **Award type:** 5
- **Project period:** 2018-06-18 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10148803

## Citation

> US National Institutes of Health, RePORTER application 10148803, Quantification of neonatal transport networks through network analysis: a new approach to studying neonatal regionalization (5K08HS025749-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10148803. Licensed CC0.

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