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A free parking trial to increase visitation and improve extremely low birth weight infant outcomes
T F Northrup1, P W Evans2, M L Lillie2
1Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX, USA.
Insights
Free parking did not significantly reduce the length of stay for extremely low birth weight infants. More effective interventions are needed to support parental visits for these vulnerable newborns.
Area of Science:
- Neonatal care
- Pediatric health outcomes
- Socioeconomic factors in healthcare
Background:
- Frequent parental visits are crucial for infants in the neonatal intensive care unit (NICU), especially for extremely low birth weight (ELBW) survivors.
- High parking costs can be a barrier for parents, particularly those with limited financial resources, potentially reducing visitation frequency.
Purpose of the Study:
- To evaluate the impact of free parking (FP) on the length of stay (LOS) for ELBW infants in the NICU.
- To determine if alleviating financial burdens associated with visitation can improve infant outcomes.
Main Methods:
- A randomized controlled trial involving 138 parents of ELBW infants (7-14 days old).
- Participants were allocated to either usual care (UC) or free parking (FP) groups.
- The primary outcome measured was the length of stay (LOS) for the infants.
Main Results:
- Among 116 survivors, no significant difference in LOS was observed between the FP and UC groups (mean LOS: 89 vs. 102 days, P=0.22).
- Proportion of visit days, parental involvement, knowledge, skills, and satisfaction did not differ significantly between groups.
- Post hoc analysis indicated that higher income, car ownership, and fewer children were associated with increased parental visits.
Conclusions:
- Free parking alone is insufficient to significantly decrease the length of stay for extremely low birth weight infants.
- More impactful interventions are required to enhance parental engagement and reduce hospital stays for infants in disadvantaged urban populations.
Objective:
Frequent parental visits are likely to benefit infants in a neonatal intensive care unit (NICU), particularly extremely low birth weight (ELBW; ⩽1000 g) survivors. Parking costs (⩾$10 per visit in our center) may deter visitation, especially for low-income parents. We assessed whether free parking (FP) decreased survivors' length of stay (LOS).
Study Design:
Parents (N=138) of ELBW infants (7 to 14 days old) were randomized to usual care (UC; n=66) or FP (n=72). The primary outcome was LOS.
Results:
Among survivors (n=116), LOS was not significantly less with FP than UC (means: FP=89, UC=102 days, P=0.22; medians: FP=82, UC=84 days, P=0.30). Groups did not differ significantly on proportion of visit days (FP=0.69, UC=0.72, P=0.47), parental involvement, knowledge/skills and satisfaction. Post hoc analyses found that parents with a greater income, a car and fewer children visited more.
Conclusion:
More potent interventions than FP are needed to increase parental visits and reduce LOS for ELBW infants in disadvantaged urban populations.
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