Transfer Patterns of Very Low Birth Weight Infants for Convalescent Care
Nansi S Boghossian1, Lucy T Greenberg2,3, Erika M Edwards2,4,3
1Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Insights
Transferring very low birth weight infants for convalescent care is low-risk. Infants transferred for convalescence and discharged had similar outcomes and length of stay (LOS) to those not transferred.
Area of Science:
- Neonatal care
- Pediatric hospital outcomes
- Healthcare quality and safety
Background:
- Transferring infants for convalescent care is a common practice.
- Variations in transfer practices exist across regions and neonatal intensive care units (NICUs).
- Understanding the outcomes of these transfers is crucial for optimizing infant care.
Purpose of the Study:
- To examine the prevalence, characteristics, clinical course, and length of stay (LOS) of infants transferred for convalescence.
- To compare outcomes among infants transferred for convalescence, those who failed transfer, and those not transferred.
- To identify regional variations in the practice of transfer for convalescence.
Main Methods:
- Analysis of data from US Vermont Oxford Network centers (2006-2020).
- Inclusion of over 641,000 very low birth weight infants.
- Categorization into four groups: transferred for convalescence and discharged, failed transfer (readmitted or re-transferred), and not transferred.
Main Results:
- 4.5% of infants were transferred for convalescent care; 9.1% of transfers failed.
- Infants transferred for convalescence and discharged had similar LOS and outcomes to infants not transferred.
- Infants who failed transfer had a longer LOS compared to those successfully discharged post-transfer.
- Significant regional variations in transfer rates were observed.
Conclusions:
- Rates of transfer for convalescence and transfer failure are low.
- Risks and benefits of transfer for convalescence may vary geographically.
- Further research is needed to weigh the risks and benefits of transfer for convalescence.
Objectives:
To examine the prevalence, characteristics, clinical course, and length of stay (LOS) among 4 groups of infants who were transferred for convalescence and subsequently discharged from the hospital; failed transfer for convalescence and were (a) either readmitted, or (b) transferred again; and were not transferred for convalescence.
Methods:
Among very low birth weight infants hospitalized at US Vermont Oxford Network centers between 2006 and 2020, we examined the distribution of characteristics, delivery room and NICU usage measures, outcomes, and LOS among the 4 groups of infants.
Results:
Among 641 712 infants, a total of 28 985 (4.5%) infants were transferred for convalescent care; of 28 186 infants, 182 (0.65%) died before hospital discharge and 2551 (9.1%) failed the transfer (1771 [6.3%] were readmitted and 780 [2.8%] were transferred again). There were major regional and NICU variations in the practice of the transfer for convalescence; New England (18.8%) had the highest whereas East South Central (2.2%) had the lowest percentage of transfer for convalescence. Infants who transferred for convalescence and were discharged from the hospital had a similar LOS and similar distribution of NICU usage measures and outcomes to infants who were not transferred for convalescence. Infants who failed the transfer for convalescence had a longer LOS than infants who were transferred for convalescence and then discharged from the hospital.
Conclusions:
The rates of transfer for convalescence and transfer for convalescence failure were low. Future studies should weigh the risks and benefits of transfer for convalescence, which might differ on the basis of geography.
