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Results from multilevel models indicated that the initiation of active treatment clustered at the hospital level. The proportion of variation in hospital rates of active treatment that was attributable to the infant’s hospital of birth was 71% (ICC, 0.71; 95% CI, 0.45 to 0.88), 38% (ICC, 0.38; 95% CI, 0.21 to 0.58), and 25% (ICC, 0.22; 95% CI, 0.06 to 0.57) for infants born at 22, 23, or 24 weeks of gestation, respectively, after adjustment for patient demographic and clinical factors. There was no significant variation in hospital rates of active treatment among infants born at 25 or 26 weeks of gestation.

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