title: Factors associated with rehospitalizations of very low birthweight infants: impact of a transition home support and education program.
abstract: OBJECTIVE
  To determine the effects of a transition-home education and support program, BPD, and health insurance type on VLBW infant rehospitalizations at 3 and 7 months corrected age. It was hypothesized that the transition-home program would be associated with decreased rehospitalizations between Phase 1 and 2, and public health insurance and BPD would be associated with increased rehospitalizations.
  
  
  METHODS
  274 infants with birth weight <1500 g were enrolled in two successive years of a transition-home program (Phase 1-start-up) and (Phase 2-full implementation) and followed to 7 months CA.
  
  
  RESULTS
  The Phase 2 rehospitalization rates were lower but not statistically significant at both 3 months (20% and 15%; p=0.246), and 7 months (24% and 17%; p=0.171). Infants with public insurance had twice as many rehospitalizations by 3 months (28% versus 11%; p=0.018) in Phase 1. In regression analyses the intervention effects did not achieve significance for the cohort at 3 months (OR=0.63; CI=0.33 to 1.20) or 7 months (OR=0.61; CI=0.33 to 1.13). BPD and public insurance did not reach significance in the models whereas siblings were significantly associated with increased odds of rehospitalization. In subgroup analyses for infants on pubic health insurance the intervention significantly decreased the odds of rehospitalization between Phase 1 and 2(OR=0.43; CI=0.19 to 0.96) at 3 months.
  
  
  CONCLUSIONS
  Our findings suggest that a transition-home program may be beneficial to reduce the rehospitalization rate for VLBW infants, and infants on public insurance may derive greater benefit.
authors: Women and Infants Hospital, Providence, RI 02905, USA. bvohr@wihri.org
authors: Betty R
authors: BR
authors: Vohr
authors: Yvette E
authors: YE
authors: Yatchmink
authors: Robert T
authors: RT
authors: Burke
authors: Bonnie E
authors: BE
authors: Stephens
authors: Ellen C
authors: EC
authors: Cavanaugh
authors: Barbara
authors: B
authors: Alksninis
authors: Julie H
authors: JH
authors: Nye
authors: Deborah
authors: D
authors: Bacani
authors: Maureen F
authors: MF
authors: McCourt
authors: Amy M
authors: AM
authors: Collins
authors: Richard
authors: R
authors: Tucker
mesh_terms: D000328:Adult; D002675:Child, Preschool; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D019102:Infant, Very Low Birth Weight / Q000502:physiology; D008020:Life Support Care / Q000706:statistics & numerical data; D010290:Parents / Q000193:education*; D019233:Retreatment / Q000706:statistics & numerical data; D012307:Risk Factors; D013663:Teaching / Q000379:methods / Q000706:statistics & numerical data; D055815:Young Adult