Abstract:
OBJECTIVE: The objective of this study was to determine predictors of health care utilization and its association with neurodevelopmental outcome in a recent cohort of preterm infants. STUDY DESIGN: A total of 405 infants (born 2008-2011) seen in neonatal intensive care unit (NICU) follow-up were compared for use of hospitalizations (hosps), emergency room (ER), subspecialties (SS), and results of the Bayley-III. High rate of use was defined as having >1 hosp, ER, or SS. Multiple regression adjusted for the effect of risk factors on high health care use. RESULTS: High hosp rate was associated with public health insurance (PHI; p = 0.021), severely abnormal head ultrasound (SAHUS; p = 0.04) at 1 year, and PHI (p = 0.011), younger gestational age (GA) (p = 0.029) at 2 years. High ER use was associated with PHI, younger GA at 1 year (p = 0.007 and 0.012) and 2 years (p = 0.010 and 0.005). High SS was associated with NICU morbidities including small for GA (p = 0.005), retinopathy of prematurity (p = 0.001), necrotizing enterocolitis (p = 0.03), and SAHUS (p = 0.045). At 20 months, infants with high hosp and SS had higher rates of cerebral palsy and significantly lower mean cognitive, language, and motor scores. CONCLUSION: Health care utilization is high among preterm infants in recent years and significantly associated with worse neurodevelopmental outcome. Further research is needed to determine if health care utilization after NICU discharge is an independent predictor of poor outcome.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Patra K,Greene MMdoi
10.1055/s-0037-1608678subject
Has Abstractpub_date
2018-04-01 00:00:00pages
441-447issue
5eissn
0735-1631issn
1098-8785journal_volume
35pub_type
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journal_title:American journal of perinatology
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journal_title:American journal of perinatology
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abstract:: ...
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