Health service utilisation of a regional cohort of very preterm infants over the first 2 years of life

Gray, Diane; Woodward, Lianne J.; Spencer, Carole A.; Inder, Terrie E.; Austin, Nicola

doi:10.1111/j.1440-1754.2006.00876.x

Cited by 34 publications

(45 citation statements)

References 25 publications

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“…Various studies across the world have tried to ascertain the neonatal risk factor for post NICU discharge hospital re-admission [1][2][3][8][9][10][11][12][13]. Ambalavanan, et al in their recent publication using classification and regression tree analysis concluded that neonates who spent > 120 days during their NICU admission for pulmonary reasons had a 66% re-hospitalization rate compared to 42% without such stay [3].…”

Section: Risk Factors For Hospital Re-admissionmentioning

confidence: 99%

“…Previous Australasian data describes a readmission rate of 42% for VLBW infants [9] and 55% for very preterm infants [2].…”

Section: Features Of In-patientsmentioning

confidence: 99%

“…Some of these papers were from the pre-surfactant era where neonatal care was significantly different from current neonatal care [15][16][17][18]. Others included very preterm infants (born before 32 weeks of gestation) and late preterm infants [2,9]. Some of them were based on weight rather than gestation age [1].…”

Section: Inpatient Admissionmentioning

confidence: 99%

“…Within Australasia there are few studies highlighting subsequent outcomes of infants born preterm [1,2,9,[14][15][16][17][18]. Some of these papers were from the pre-surfactant era where neonatal care was significantly different from current neonatal care [15][16][17][18].…”

Section: Inpatient Admissionmentioning

confidence: 99%

“…Re-hospitalization after initial discharge from NICU for preterm infants has been examined in various settings across the world [1][2][3][4][5][6][7][8][9][10][11][12][13]. Reasons for re-hospitalizations in extreme preterm infants can be related either to medical (bronchiolitis, lower-respiratory tract infection, asthma, reflux disease) or to surgical (PEG related problems, V-P shunt related issues, hernia repair) causes.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Hospital Readmission and Follow Up after NICU Discharge of Infants Born at Extremely Low Gestational Age in Metropolitan Melbourne

et al. 2017

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Section: Risk Factors For Hospital Re-admissionmentioning

confidence: 99%

“…Previous Australasian data describes a readmission rate of 42% for VLBW infants [9] and 55% for very preterm infants [2].…”

Section: Features Of In-patientsmentioning

confidence: 99%

Section: Inpatient Admissionmentioning

confidence: 99%

Section: Inpatient Admissionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Hospital Readmission and Follow Up after NICU Discharge of Infants Born at Extremely Low Gestational Age in Metropolitan Melbourne

et al. 2017

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Community Supports After Surviving Extremely Low-Birth-Weight, Extremely Preterm Birth

Hintz

Kendrick²,

Vohr³

et al. 2008

Arch Pediatr Adolesc Med

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Objective To determine special outpatient services (SOS) use, need, associated factors, and neurodevelopmental and functional outcomes among extremely preterm infants at 18 to 22 months’ corrected age. Design Retrospective analysis. Setting National Institute of Child Health and Human Development (NICHD) Neonatal Research Network. Participants Infants younger than 28 weeks’ gestational age who had been born weighing less than 1000 g at an NICHD Neonatal Research Network center from January 1, 1997, to December 31, 2000, and who were receiving follow-up at 18 to 22 months’ corrected age. Interventions Questionnaires were administered at the 18- to 22-month follow-up visit regarding SOS use since hospital discharge and the current need for SOS (social work, visiting nurse, medical specialty, early intervention, speech and language services, occupational therapy and physical therapy, and neurodevelopmental and behavioral services). Main Outcome Measures The use of and need for SOS were analyzed by gestational age. Logistic regression analysis identified factors independently associated with the use of more than 5 services and with the need for any services. Results Of 2315 infants, 54.7% used more than 3 SOS by 18 to 22 months, and 19.1% used 6 to 7 SOS. The need for any SOS was reported by approximately 37%. The following variables that were commonly associated with adverse neurodevelopmental outcomes were also associated with the use of more than 5 SOS: sepsis, birth weight, postnatal corticosteroid use, bronchopulmonary dysplasia, and cystic periventricular leukomalacia or grade 3 or 4 intraventricular hemorrhage. Male sex was associated with the need for any SOS. Although high SOS use was more likely among children with adverse neurodevelopmental outcomes, a reported need for SOS was common even among those with mild developmental impairment (39.7%) and mild cerebral palsy (42.2%). Conclusions High SOS use is common, has identifiable neonatal risk factors, and is associated with neurodevelopmental impairment. Extremely preterm survivors have substantial need for community supports regardless of their impairment level. Efforts to improve comprehensive delivery of family-centered community-based services are urgently needed.

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Hospital Costs and Quality of Life During 4 Years After Very Preterm Birth

Korvenranta

Linna²,

Rautava³

et al. 2010

Arch Pediatr Adolesc Med

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To evaluate the effect of gestational age and prematurity-related morbidities on hospital costs and cost per quality-adjusted life-year (QALY) during the first 4 years of life.Design: Population-based study using national register data and parental questionnaires. Setting: Finland. Participants: All 2064 very preterm children (gestational age Ͻ32 weeks or birth weight Ͻ1501 g) and all 200 609 full-term control individuals (mean [SD] gestational age, 37 [0] to 41 [6] weeks) born from January 1, 2000, through December 31, 2003. Main Exposure: Prematurity. Main Outcome Measures: Costs of hospital care and cost per QALY at 4 years of age according to gestational age and prematurity-related morbidities. Results: By 4 years of age, the cost per QALY for fullterm controls (in 2008 currency) was €1181 (US$1736). In very preterm children, the average cost per QALY was €19 245 ($28 290), ranging from €11 824 to €54 324 ($17 381 to $79 856) and increasing with decreasing gestational age. The cost per QALY was €14 368 ($21 121)for those without any of the studied morbidities and €36 110 ($53 082) for those with 2 or more morbidities. The costs of the initial hospital stay comprised 79.5% of the total 4-year hospital costs in very preterm children. Conclusions:We conclude that the cost per QALY in this patient group is at an acceptable level by 4 years of age. Because the initial hospital care episode accounted for most of the costs, the cost per QALY will decrease with each additional follow-up year.

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Health service utilisation of a regional cohort of very preterm infants over the first 2 years of life

Abstract: Very preterm infants had higher rates of hospital admissions and visits than term infants unrelated to neurodevelopmental outcome at 2 years of age. These findings highlight that very preterm birth is associated with ongoing health morbidity.

Cited by 34 publications

References 25 publications

Risk Factors for Hospital Readmission and Follow Up after NICU Discharge of Infants Born at Extremely Low Gestational Age in Metropolitan Melbourne

Risk Factors for Hospital Readmission and Follow Up after NICU Discharge of Infants Born at Extremely Low Gestational Age in Metropolitan Melbourne

Community Supports After Surviving Extremely Low-Birth-Weight, Extremely Preterm Birth

Hospital Costs and Quality of Life During 4 Years After Very Preterm Birth

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