title: Trends and challenges in United States neonatal intensive care units follow-up clinics.
abstract: OBJECTIVE
  A mandate exists that all level III neonatal intensive care units (NICUs) provide a means to assess and follow their high-risk neonates after discharge. However, no standardized guidelines exist for the follow-up services provided. To determine trends of structure and care provided in NICU follow-up clinics in both the academic and private clinical setting.
  
  
  METHODS
  We sent an Internet survey to NICU follow-up clinic directors at both academically affiliated and private centers. This study received institutional review board exemption.
  
  
  RESULTS
  We received 89 surveys from academic institutions and 94 from private level III follow-up programs. These responses represent 55% of academic programs and 40% of private programs in the United States. Similar to academic institutions, 18% of private NICU follow-up clinics provide primary care services to patients. In both settings, the hospital supports 60% of the funding required for clinic activities. Forty-five percent of NICU graduates seen in both private and academic follow-up clinics have public aid as their primary insurance. Eighty-five percent of NICUs in both settings have guidelines outlining requirements for referrals to the follow-up clinic. Academic programs find feeding difficulties the most difficult, whereas private programs find bronchopulmonary dysplasia and feeding difficulties equally as difficult.
  
  
  CONCLUSIONS
  The care and struggles of NICU follow-up clinics are similar in both the academic affiliated and private settings. Similar referrals, clinical evaluation and medical care occur with varying struggles.
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Chicago, Chicago, IL, USA.
authors.forename: K
authors.initials: K
authors.lastname: Bockli
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Chicago, Chicago, IL, USA.
authors.forename: B
authors.initials: B
authors.lastname: Andrews
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Chicago, Chicago, IL, USA.
authors.forename: M
authors.initials: M
authors.lastname: Pellerite
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Chicago, Chicago, IL, USA.
authors.forename: W
authors.initials: W
authors.lastname: Meadow
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000639:trends; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration* / Q000639:trends; D014481:United States