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Profile of Back-Referrals to Special Newborn Care Units
Soumalya Chakraborty1, Suresh Kumar Angurana1, Shiv Sajan Saini1
1Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh.
Objective:
To study the outcomes of neonates back-referred from a tertiary care centre to special newborn care units (SNCUs) for step-down care.
Methods:
This prospective cohort study was conducted at a tertiary care neonatal unit and SNCUs in neighbouring states. We studied preterm and term neonates back-referred to district SNCUs from September, 2018 to April, 2019. The infants were followed up till 3 months corrected age, for mortality, re-hospitalization, emergency visits and unscheduled outpatient visits. Preterm inborn neonates <32 weeks gestation discharged directly to home formed the controls.
Results:
201 back-referred neonates (study cohort) and 55 preterm neonates discharged to home (controls) were followed up till 3 months corrected age. Amongst the back-referred neonates, 5% died, 7% required re-hospitalization, 11% made emergency visits, and 24% made unscheduled outpatient visits. These outcomes were similar to the controls.
Conclusion:
Back-referral of convalescing neonates is a safe method of utilizing the limited healthcare resources in tertiary care centers in developing country settings.
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