Very low birth weight infants and their families during the first year of life: comparisons of medical outcomes based on after care services.
OBJECTIVE
To evaluate factors contributing to optimal medical outcomes during the first year following discharge of very low birth weight infants from tertiary neonatal intensive care units.


METHODS
This was a prospective investigation of the health and development of 81 very low birth weight infants following discharge from two tertiary neonatal intensive care units in Los Angeles. Infants were assigned to four groups receiving a variety of after care services in their homes. Analyses of variance were computed to examine differences between groups for a variety of outcomes.


RESULTS
No statistically significant differences were seen between after care groups on use of hospital emergency rooms (ER) rehospitalization rates, or child abuse and neglect. Highest overall rates of optimal outcomes were seen in the group receiving the highest intensity of after care services. Those groups receiving long-term home visiting services had significantly higher rates of up-to-date immunizations.


CONCLUSIONS
There was no significant impact on infant mortality and morbidity of early discharge, regardless of the system of after care used. However, those infants who received the highest level of after care services had the most optimal health outcomes and were most likely to be receiving well-baby care. It is likely that the comprehensive, clinic-based system of health care available to all study infants was a significant factor in low rates of morbidity.
Finello
K M
KM
Department of Pediatrics, University of Southern California Center for Pediatric Health Outcomes Research, University of Southern California, Los Angeles 90033, USA.
Litton
K M
KM
deLemos
R
R
Chan
L S
LS
D000359:Aftercare / Q000379:methods*; D002649:Child Abuse / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005190:Family; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D007902:Length of Stay / Q000706:statistics & numerical data; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors