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Create a prioritization framework for value-based improvement in neonatal care. A retrospective cohort study of very low birth weight (1500 g) and/or very preterm (32 weeks) infants discharged between 2012 and 2019 using the Pediatric Health Information System Database. Resource use was compared across hospitals and adjusted for patient-level differences. A prioritization score was created combining cost, patient exposure, and inter-hospital variability to rank resource categories. Resource categories with the greatest cost, pat