Convalescent care of infants in the neonatal intensive care unit in community hospitals: Risk or benefit?

Pamela K. Donohue, Brenda Hussey-Gardner, Leslie J. Sulpar, Renee Fox, Susan W. Aucott

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)105-111
Number of pages7
JournalPediatrics
Volume124
Issue number1
DOIs
StatePublished - Jul 1 2009

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Keywords

  • Community medicine
  • NICU
  • Prematurity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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