Improving health care usage in a very low birth weight population

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• 作者：Wambui Waruingi ; Sai Iyer ; Marc Collin
• 关键词：health care usage ; special care clinic ; very low birth weight
• 刊名：World Journal of Pediatrics
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：11
• 期：3
• 页码：239-244
• 全文大小：566 KB
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• 作者单位：Wambui Waruingi (1) (2) (3)
  Sai Iyer (1)
  Marc Collin (1)
  
  1. Department of Pediatrics, Division of Neonatology, Case Western Reserve, Metrohealth Medical Center, 2500 Metrohealth Drive, Cleveland, OH, 44109, USA
  2. Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnett avenue, Cincinnati, OH, 45229, USA
  3. Cincinnati Children’s Hospital, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
  
• 刊物主题：Pediatrics; Pediatric Surgery; Maternal and Child Health; Intensive / Critical Care Medicine; Surgery; Imaging / Radiology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1867-0687

文摘

Background Prematurity is the biggest contributor to admissions in the neonatal intensive care unit (NICU). The period following hospital discharge is a vital continuum for the very low birth weight (VLBW) infant. The objective of this study was to assess the impact of a unique discharge and follow-up process on the outcomes of VLBW infants leaving the NICU. Methods All outpatient health care usage by VLBW infants born in the study year (cases) was retrospectively tracked through 12 months of age. A cohort of healthy newborn infants were matched by birthdate to each VLBW infant (controls) and similarly tracked. Results In this study, there were 85 cases and 85 controls. The mean gestational age at birth for the cases was 29.1±2.7 weeks with a mean birth weight of 1079±263 g. That of the controls was 38.9±1.3 weeks and 3202±447 g. Over 90% of both populations had Medicaid coverage. All VLBW infants received care at the Special Care Developmental Follow-Up Clinic. When compared with the controls, VLBW infants discharged from the NICU made fewer acute, unscheduled visits to the Emergency Department or Urgent Care Clinic (2.3±2.5 vs. 3.7±3.5; P=0.007) despite their high-risk medical and social status. Their growth pattern showed significant “catch-up-and was similar to the matched controls at the last scheduled visit for each group. Conclusions Outcomes including health care utilization in high-risk infants can be improved through meticulous discharge planning and follow-up measures that utilize existing hospital infrastructure to provide affordable comprehensive care.