title: Impact of community neonatal services: a multicentre survey.
abstract: OBJECTIVE
  To explore the impact of a community neonatal service on high risk infant survivors in the first year of life.
  
  
  METHODS
  Retrospective multicentre survey. Postal questionnaires were sent to selected parents.
  
  
  METHODS
  Thirty two neonatal units in England and Wales.
  
  
  METHODS
  
  
  
  METHODS
  infants over 12 months of age with birth weight < or =1500 g, or who received level I intensive care for at least 48 hours.
  
  
  METHODS
  multiple births, infants who had died or had severe congenital abnormalities. A total of 3367 eligible infants were selected, and their parents were sent a questionnaire; 65% responded.
  
  
  METHODS
  Length of stay on the neonatal unit from birth to initial discharge. Readmission to hospital during the first year of life.
  
  
  RESULTS
  The median length of stay in units with a community neonatal service was 35 days compared with 37 days in units without. When adjusted for infant and parent characteristics, the median length of stay was reduced by 12.6% where a community neonatal service was provided (95% confidence interval 5.3% to 19.3%). The readmission rates were 44.6% in units with a community neonatal service and 43.5% in units without. There was no significant reduction in the adjusted odds of readmission.
  
  
  CONCLUSIONS
  The retrospective nature of this study means that these findings cannot be definitely attributed to the presence of a community neonatal service. However, the results suggest that community neonatal services may reduce the length of stay without any subsequent increase in readmission.
authors.affiliation: Health R & D NoW, Institute for Health Research, Bowland Tower East, Lancaster University, UK. d.langley@lancaster.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Langley
authors.forename: S
authors.initials: S
authors.lastname: Hollis
authors.forename: T
authors.initials: T
authors.lastname: Friede
authors.forename: D
authors.initials: D
authors.lastname: MacGregor
authors.forename: A
authors.initials: A
authors.lastname: Gatrell
mesh_terms: D003153:Community Health Services / Q000592:standards* / Q000706:statistics & numerical data; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal / Q000592:standards* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D018743:Perinatal Care / Q000592:standards* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors; D014852:Wales