Home Visiting for NICU Graduates: Impacts of Following Baby Back Home
Home Visiting for NICU Graduates: Impacts of Following Baby Back Home
复制标题
DOI：
10.1542/peds.2020-029397
复制
发表时间：
2021-07-01
期刊：
影响因子：
8
通讯作者：
Goudie, Anthony
中科院分区：
文献类型：
--
作者：
McKelvey, Lorraine M.;Lewis, Kanna N.;Goudie, Anthony
背景和目的以下婴儿回家(FBBH)家庭访问计划支持高危低出生体重早产儿出院后的家庭。这项研究比较了在FBBH登记的低出生体重早产儿和不在该计划中的类似婴儿的卫生保健使用、免疫接种和婴儿死亡率。方法从2013年1月至2017年12月，在阿肯色州生命统计记录和阿肯色州所有付款人索赔数据库中确定498名登记在FBBH的儿童的身份。FBBH中的婴儿根据婴儿的人口学和医疗条件与对照组的儿童进行匹配。采用双重倾向-得分调整的广义线性混合模型对项目效果进行评估。结果在出院后第一年，与倾向分数匹配的对照组婴儿相比，参加FBBH的婴儿更有可能有更多的就诊次数和更符合要求的免疫史。对照组婴儿出生一年内死亡的几率是计划中管理婴儿的4.4倍(95%可信区间：1.2-20.7)。结论FBBH家访计划的一个目标是与父母合作，在他们照顾他们的医疗脆弱婴儿时教育和支持他们。我们得出的结论是，教育和支持对我们观察到的婴儿在出生第一年的卫生保健使用和结局差异起到了重要作用。
BACKGROUND AND OBJECTIVES The Following Baby Back Home (FBBH) home visiting program supports families of high-risk low birth weight preterm infants after discharge from a hospital NICU. This study compares the health care use, immunization, and infant mortality rate of low birth weight preterm infants enrolled in FBBH with similar infants not in the program. METHODS From January 2013 to December 2017, 498 children enrolled in FBBH were identified in Arkansas vital statistics records and the Arkansas All-Payer Claims Database. Infants in FBBH were matched with children in a control group on the basis of demographics and medical conditions of the infant. Generalized linear mixed models with double propensity-score adjustment were used to estimate program effects. RESULTS In the first year after discharge and compared with a propensity-score matched cohort of control infants, those enrolled in FBBH were significantly more likely to have higher numbers of medical appointments and more compliant immunization history. The odds of dying in the first year of life for control infants was 4.4 times (95% confidence interval: 1.2-20.7) higher than those managed in the program. CONCLUSIONS A goal of the FBBH home visiting program is to work with parents to educate and support them as they care for their medically fragile infants. We conclude that education and support was instrumental in the infant health care use and outcome differences we observed during the first year of life.