Document Detail


Convalescent care of infants in the neonatal intensive care unit in community hospitals: risk or benefit?
MedLine Citation:
PMID:  19564289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare very low birth weight (VLBW) infants transported to a community hospital (CH) before discharge with infants who received convalescent care in a regional-referral NICU (RR-NICU) on 4 parameters: health indicators at the time of hospital discharge, health care use during the 4 months after discharge to home, parent satisfaction with hospital care, and cost of hospitalization. PATIENTS AND METHODS: VLBW infants cared for in 2 RR-NICUs during 2004-2006 were enrolled in the study. One RR-NICU transfers infants to a CH for convalescent care and the other discharges infants directly home. Infants were followed prospectively. Information was gathered from medical charts, parent interviews, and hospital business offices. RESULTS: A total of 255 VLBW infants were enrolled in the study, and 148 were transferred to 15 CHs. Nineteen percent of transferred infants were readmitted to a higher level of care before discharge from the hospital. Preventative health measures and screening examinations were more frequently missed, readmission within 2 weeks of discharge from the hospital was more frequent, parents were less satisfied with hospital care, and duration of hospitalization was 12 days longer, although not statistically different, if infants were transferred to a CH for convalescence rather than discharged from the RR-NICU. Total hospital charges did not differ significantly between the groups. CONCLUSION: Transfer of infants to a CH from an RR-NICU for convalescent care has become routine but may place infants at risk. Our study indicates room for improvement by both CHs and RR-NICUs in the care of transferred VLBW infants.
Authors:
Pamela K Donohue; Brenda Hussey-Gardner; Leslie J Sulpar; Renee Fox; Susan W Aucott
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  124     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-30     Completed Date:  2009-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. pdonohu2@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Baltimore
Convalescence*
Hospitalization / economics
Hospitals, Community*
Humans
Infant, Newborn
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal*
Logistic Models
Nurseries, Hospital
Patient Transfer*
Poverty
Urban Population

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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