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Rehospitalization in the first year of life for high-risk survivors
Insights
Infant rehospitalization is common, especially for low birth weight infants. While maternal health, socioeconomic factors, and infant care influence risk, no single subgroup significantly reduces overall infant hospital days.
Area of Science:
- Pediatrics
- Public Health
- Health Services Research
Background:
- The first year of life sees high morbidity and healthcare utilization, particularly for low birth weight infants.
- Understanding risk factors for infant rehospitalization is crucial for optimizing healthcare resource allocation.
Purpose of the Study:
- To identify specific factors associated with increased risk of rehospitalization in 1-year-old infants.
- To examine whether these risk factors differ between low birth weight and normal birth weight infants, with or without congenital anomalies/developmental delay.
Main Methods:
- Analysis of a large random sample (N = 4,989) of 1-year-old infants.
- Rehospitalization within the first year of life was used as the primary dependent variable.
- Statistical examination of factors including birth weight, congenital anomalies, maternal hospitalization, socioeconomic status, and medical care use.
Main Results:
- Overall, 9.1% of infants were rehospitalized; this rate increased significantly with lower birth weight (38.2% for infants ≤1,500 gm).
- Low birth weight infants constituted a disproportionate share of hospitalizations and hospital days.
- Factors like maternal hospitalization during pregnancy, prolonged infant postnatal stay, low socioeconomic status, and specific medical care patterns were linked to higher rehospitalization risk.
- Risk factors for rehospitalization were similar across low birth weight and normal birth weight infants, irrespective of congenital anomalies/developmental delay.
Conclusions:
- While several factors increase infant rehospitalization risk, it is challenging to pinpoint a specific subgroup whose reduced hospitalization would lead to a major decrease in overall infant hospital utilization.
- Further research may be needed to identify targeted interventions for high-risk infant populations.
Abstract:
The first year of life is an age when morbidity and medical care use is high, and this is particularly true for low birth weight infants. Whether certain factors characterize subgroups at especially increased risk was examined for a large random sample (N = 4,989) of 1-year-old infants by using rehospitalization as the dependent variable. Overall, 9.1% of the infants had been rehospitalized, and this increased with decreasing birth weight to 38.2% of those less than or equal to 1,500 gm at birth. Low birth weight infants accounted for 6.4% of 1-year-olds, but 13.6% of those hospitalized and 20.0% of all hospital days among these infants. Factors affecting the chances of rehospitalization for low birth weight and normal birth weight infants, with and without congenital anomalies/developmental delay, were similar. Maternal hospitalization during pregnancy, prolonged postnatal stay of the infant, variables indicative of low socioeconomic status, and certain types of medical care use were associated with increased risk of hospitalization. The risk of hospitalization associated with some variables was high, but it was not possible to identify with precision a group where reduction in hospitalization would result in major decrease in overall hospital use by infants.