Care System Redesign for Preterm Children After Discharge From the NICU

Kuo, Dennis Z.; Lyle, Robert; Casey, Patrick H.; Stille, Christopher J.

doi:10.1542/peds.2016-2969

Cited by 48 publications

(33 citation statements)

References 52 publications

(36 reference statements)

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“…Post-discharge plans along with care coordination and co-management that connects parents of children born prematurely to medical homes at or affiliated with a larger integrated healthcare system (e.g., healthcare systems providing pediatric therapy services and adult health services) may make medical home access more logistically feasible for parents needing specialty and therapy services for their child, as well as healthcare for themselves. (46,47) Future research in this area may benefit from qualitative inquiry with both parents and healthcare providers to determine additional strategies better facilitating medical home access for children born prematurely.…”

Section: Resultsmentioning

confidence: 99%

Healthcare Access and Adverse Family Impact among U.S. Children ages 0-5 years by Prematurity Status

Lindly

Crossman

Shui

et al. 2019

Preprint

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Background: Many children and their families are affected by premature birth. Yet, little is known about their healthcare access and adverse family impact in early childhood. This study aimed to (1) examine differences in healthcare access and adverse family impact among young children by prematurity status and (2) determine associations of healthcare access with adverse family impact among young children born prematurely. Methods: This was a secondary analysis of cross-sectional 2016 and 2017 National Survey of Children’s Health data. The sample included 19,482 U.S. children ages 0-5 years including 242 very low birthweight (VLBW) and 2,205 low birthweight and/or preterm (LBW/PTB) children. Prematurity status was defined by VLBW (i.e., <1,500 grams at birth) and LBW/PTB (i.e., 1,500-2,499 grams at birth and/or born at <37 weeks with or without low birthweight). Healthcare access measures were adequate health insurance, medical home, and developmental screening receipt. Adverse family impact measures were ≥$1,000 annual out-of-pocket medical costs, having a parent cut-back or stop work, parental aggravation, maternal health not excellent, and paternal health not excellent. The relative risk of each healthcare access and adverse family impact measure was computed by prematurity status. Propensity weighted models were fit to estimate the average treatment effect of each healthcare access measure on each adverse family impact measure among children born prematurely (i.e., VLBW or LBW/PTB). Results: Bivariate analysis results showed that VLBW and/or LBW/PTB children generally fared worse than other children in terms of medical home, having a parent cut-back or stop working, parental aggravation, and paternal health. Multivariable analysis results only showed, however, that VLBW children had a significantly higher risk than other children of having a parent cut-back or stop work. Adequate health insurance and medical home were each associated with reduced adjusted relative risk of ≥$1,000 in out-of-pocket costs, having a parent cut-back or stop work, and parental aggravation among children born prematurely. Conclusions: This study’s findings demonstrate better healthcare access is associated with reduced adverse family impact among U.S. children ages 0-5 years born prematurely. Population health initiatives should target children born prematurely and their families.

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Section: Resultsmentioning

confidence: 99%

Healthcare Access and Adverse Family Impact among U.S. Children ages 0-5 years by Prematurity Status

Lindly

Crossman

Shui

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…For these reasons, further efforts are needed to ensure children born prematurely have a medical home after NICU discharge. Post-discharge plans along with care coordination and co-management that connects parents of children born prematurely to medical homes at or affiliated with a larger integrated healthcare system (e.g., healthcare systems providing pediatric therapy services and adult health services) may make medical home access more logistically feasible for parents needing specialty and therapy services for their child, as well as healthcare for themselves [53,54]. Past qualitative inquiry conducted to understand parent and healthcare provider experiences around the time of NICU discharge may provide a foundation for future efforts to better facilitate medical home access for children born prematurely [55][56][57][58].…”

Section: Discussionmentioning

confidence: 99%

Healthcare access and adverse family impact among U.S. children ages 0–5 years by prematurity status

et al. 2020

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Background: Many children and their families are affected by premature birth. Yet, little is known about their healthcare access and adverse family impact during early childhood. This study aimed to (1) examine differences in healthcare access and adverse family impact among young children by prematurity status and (2) determine associations of healthcare access with adverse family impact among young children born prematurely. Methods: This was a secondary analysis of cross-sectional 2016 and 2017 National Survey of Children's Health data. The sample included 19,482 U.S. children ages 0-5 years including 242 very low birthweight (VLBW) and 2205 low birthweight and/or preterm (LBW/PTB) children. Prematurity status was defined by VLBW (i.e., < 1500 g at birth) and LBW/PTB (i.e., 1500-2499 g at birth and/or born at < 37 weeks with or without LBW). Healthcare access measures were adequate health insurance, access to medical home, and developmental screening receipt. Adverse family impact measures were ≥ $1000 in annual out-of-pocket medical costs, having a parent cutback or stop work, parental aggravation, maternal health not excellent, and paternal health not excellent. The relative risk of each healthcare access and adverse family impact measure was computed by prematurity status. Propensity weighted models were fit to estimate the average treatment effect of each healthcare access measure on each adverse family impact measure among children born prematurely (i.e., VLBW or LBW/PTB). Results: Bivariate analysis results showed that VLBW and/or LBW/PTB children generally fared worse than other children in terms of medical home, having a parent cutback or stop working, parental aggravation, and paternal health. Multivariable analysis results only showed, however, that VLBW children had a significantly higher risk than other children of having a parent cutback or stop work. Adequate health insurance and medical home were each associated with reduced adjusted relative risk of ≥$1000 in annual out-of-pocket costs, having a parent cutback or stop work, and parental aggravation among children born prematurely. Conclusions: This study's findings demonstrate better healthcare access is associated with reduced adverse family impact among U.S. children ages 0-5 years born prematurely. Population health initiatives should target children born prematurely and their families.

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“…With the advances in neonatal care, the number of preterm infants and critically ill term infants who survive and are discharged from the Neonatal Intensive Care Unit (NICU) continues to increase [10] .…”

Section: Neonatal Resuscitation Programmentioning

confidence: 99%

Audit of Golden Hour Practice in Neonate Assiut University Children Hospital

Mohamed¹,

Embaby

2019

The Medical Journal of Cairo University

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Background: A golden-hour strategy is a philosophical approach that reinforces communication and collaboration (inter-and intra-team) using evidence-based protocols and procedures that standardize as many elements as possible for delivery and initial management of a newborn. Golden-hour strategies lay out how the neonatal team will receive notification from the obstetrical service of an impending periviable birth and stress the importance of collaborative counseling of the family. The Vermont Oxford Network (VON), a worldwide nonprofit collaborative of neonatal healthcare providers, began to use "golden hour" to describe the first hour of life for the Very Low Birth Weight (VLBW) infant in the late 1990s. Pre-resuscitation check lists are used for briefing the care team to the equipment that they will need to prepare both in the delivery room and Neonatal Intensive Care Unit (NICU) in the form of standardized check lists. Personnel have clearly assigned roles and responsibilities. This promotes training and adherence to the American Academy of Pediatrics/ American Heart Association Neonatal Resuscitation Program (NRP) algorithm. Aim of Study: The aim of the study is to assess the degree of adherence of medical physician to Assiut University Children Hospital protocol for application of golden hour practice in neonate. Also to review potentially better practice that can be applied during the golden hour to ensure the optimal outcome. Patients and Methods: The study included 100 cases that were delivered at Assiut University Maternal Health Hospital and followed-up during the first hour of life. The included cases were chosen according to the inclusion criteria and the data was collected during the period between October 2016 to March 2017. Results: The study included 100 newborn infants their gestational ages ranged from >29 weeks to <40 weeks, 51 cases were males and 49 were females. Data of the study showed how much the degree of adherence of medical physician to the agreed up on protocol of golden hour practice in

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Care System Redesign for Preterm Children After Discharge From the NICU

Cited by 48 publications

References 52 publications

Healthcare Access and Adverse Family Impact among U.S. Children ages 0-5 years by Prematurity Status

Healthcare Access and Adverse Family Impact among U.S. Children ages 0-5 years by Prematurity Status

Healthcare access and adverse family impact among U.S. children ages 0–5 years by prematurity status

Audit of Golden Hour Practice in Neonate Assiut University Children Hospital

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