Implications of continuity of care on infant caloric intake in the neonatal intensive care unit
Kerri Z Machut1,2, Daniel T Robinson3,4, Karna Murthy3,4,5
1Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. k-machut@northwestern.edu.
Insights
Neonatologist care continuity positively impacts caloric intake in very low birth weight (VLBW) infants, particularly in the initial weeks. However, this continuity did not show a significant association with growth velocity in VLBW infants.
Area of Science:
- Neonatal Medicine
- Healthcare Quality Improvement
- Pediatric Nutrition
Background:
- Continuity of care is crucial for optimizing infant health outcomes.
- Understanding the impact of neonatologist care continuity on nutritional status in vulnerable infants is essential.
Purpose of the Study:
- To investigate the association between neonatologist care continuity and caloric intake and growth velocity in very low birth weight (VLBW) infants.
- To quantify the relationship between a daily continuity index and infant nutritional parameters.
Main Methods:
- A daily continuity index (DCI) was developed, measuring neonatologist workdays in the preceding week.
- Regression analyses were used to assess the association of DCI with daily caloric intake and growth velocity over the first six weeks of life.
- The study included 115 VLBW infants cared for by 28 neonatologists.
Main Results:
- A significant positive association was found between neonatologist continuity and increased caloric intake (β = 1.27 kcal/kg/day per day of continuity, p < 10⁻⁴).
- This association was more pronounced during the first two weeks of life (β = 3.33, p < 10⁻⁴).
- No significant association was observed between neonatologist continuity and growth velocity (GV) in VLBW infants.
Conclusions:
- Neonatologist care continuity may play a role in enhancing caloric intake for VLBW infants.
- Further research into quality metrics for healthcare delivery in neonatal intensive care is warranted.
- The findings suggest a potential benefit of consistent neonatologist care for nutritional support in VLBW infants.
Objective:
To estimate the association of continuity of neonatologist care with caloric intake and growth velocity (GV) in very low birth weight (VLBW) infants.
Study Design:
We created a daily continuity index (DCI) defined as the number of days the neonatologist worked in the previous week. We estimated the independent associations between this index and infants' daily caloric intake (kcal/kg/day) and GV (g/kg/day) through the first 6 weeks of life using regression analyses.
Results:
Twenty-eight neonatologists cared for 115 infants over 4643 patient-days. The DCI was independently associated with increased caloric intake (β = 1.27 kcal/kg/day per each day of continuity, p < 10-4); this effect was magnified (β = 3.33, p < 10-4) in the first 2 weeks. No association was observed between the index and GV.
Conclusions:
Neonatologist continuity may contribute to caloric intake in VLBW infants. Quality metrics focused on this area of health care delivery warrant further discovery.
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