Published online June 29, 2009
PEDIATRICS Vol. 124 No. 1 July 2009, pp. 105-111 (doi:10.1542/peds.2008-0880)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Google Scholar
Right arrow Articles by Donohue, P. K.
Right arrow Articles by Aucott, S. W.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Donohue, P. K.
Right arrow Articles by Aucott, S. W.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Convalescent Care of Infants in the Neonatal Intensive Care Unit in Community Hospitals: Risk or Benefit?

Pamela K. Donohue, ScDa,b, Brenda Hussey-Gardner, PhDc, Leslie J. Sulpar, MSNa, Renee Fox, MDc and Susan W. Aucott, MDa

a Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
b Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
c Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland

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.

Key Words: community medicine • NICU • prematurity

Abbreviations: CH—community hospital • VLBW—very low birth weight • RR-NICU—regional-referral NICU

Accepted Feb 5, 2009.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?