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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Impact of community neonatal services: a multicentre survey
D Langley1, S Hollis, T Friede
1Health R & D NoW, Institute for Health Research, Bowland Tower East, Lancaster University, UK. d.langley@lancaster.ac.uk
Insights
Community neonatal services may reduce infant hospital length of stay without increasing readmissions. This study explored the impact of these services on high-risk infant survivors during their first year.
Area of Science:
- Neonatal care
- Public health
- Pediatric outcomes
Background:
- High-risk infants require specialized care post-discharge.
- Community neonatal services aim to bridge the gap between hospital and home care.
- Evaluating the effectiveness of these services is crucial for optimizing infant outcomes.
Purpose of the Study:
- To assess the impact of community neonatal services on high-risk infant survivors.
- To determine the effect on length of hospital stay and readmission rates within the first year of life.
Main Methods:
- Retrospective multicentre survey of 3367 eligible infants across 32 neonatal units in England and Wales.
- Data collected via postal questionnaires sent to parents of infants with birth weight ≤1500g or requiring level I intensive care for ≥48 hours.
- Main outcome measures included length of neonatal unit stay and hospital readmission rates in the first year.
Main Results:
- Median length of stay was reduced by 12.6% in units with community neonatal services (adjusted analysis).
- No significant difference in readmission rates was observed between units with and without community neonatal services (44.6% vs 43.5%).
Conclusions:
- Community neonatal services may be associated with a reduced length of stay for high-risk infants.
- The study suggests these services do not lead to an increased risk of hospital readmission.
- Further research is needed to definitively attribute causality due to the retrospective study design.
Objectives:
To explore the impact of a community neonatal service on high risk infant survivors in the first year of life.
Design:
Retrospective multicentre survey. Postal questionnaires were sent to selected parents.
Setting:
Thirty two neonatal units in England and Wales.
Inclusion Criteria:
infants over 12 months of age with birth weight < or =1500 g, or who received level I intensive care for at least 48 hours.
Exclusion Criteria:
multiple births, infants who had died or had severe congenital abnormalities. A total of 3367 eligible infants were selected, and their parents were sent a questionnaire; 65% responded.
Main Outcome Measures:
Length of stay on the neonatal unit from birth to initial discharge. Readmission to hospital during the first year of life.
Results:
The median length of stay in units with a community neonatal service was 35 days compared with 37 days in units without. When adjusted for infant and parent characteristics, the median length of stay was reduced by 12.6% where a community neonatal service was provided (95% confidence interval 5.3% to 19.3%). The readmission rates were 44.6% in units with a community neonatal service and 43.5% in units without. There was no significant reduction in the adjusted odds of readmission.
Conclusions:
The retrospective nature of this study means that these findings cannot be definitely attributed to the presence of a community neonatal service. However, the results suggest that community neonatal services may reduce the length of stay without any subsequent increase in readmission.
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