title: Hospital-assisted home care after early discharge from a Swedish neonatal intensive care unit was safe and readmissions were rare.
abstract: OBJECTIVE
  It is common in Sweden to discharge infants early from a neonatal intensive care unit (NICU) and provide hospital-assisted neonatal home care (HANHC), as an alternative to hospital care, for infants with a persisting need for specialised care. This study assessed the safety of HANHC by reviewing hospital readmissions.
  
  
  METHODS
  We retrospectively reviewed the files of all 1410 infants enrolled in HANHC at the NICU at Sachs' Children's Hospital, Stockholm, from 2002 to 2011 up until hospital readmission or their discharge from HANHC. Each readmitted infant was matched to the next HANHC infant who was not readmitted. Predictors and reasons for readmission were investigated in a retrospective nested case-control study.
  
  
  RESULTS
  We readmitted 74 (5.2%) of the 1410 infants in HANHC. Extremely preterm infants, born at less than 28 weeks, were readmitted more frequently than other infants, with an odds ratio of 6.07 (range 2.06-17.8). The most common symptoms were respiratory symptoms (55%), and viral respiratory tract infections were the most common reason (28%) for readmission.
  
  
  CONCLUSIONS
  HANHC was safe for the vast majority of infants (94.8%). Extremely preterm birth was identified as a predictor for hospital readmission. Further studies investigating the safety of HANHC in other settings would be valuable.
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Sachs' Children's Hospital, Stockholm, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Lundberg
authors.affiliation: 1177 Vårdguiden, Stockholm, Sweden.
authors.forename: Carl
authors.initials: C
authors.lastname: Lindgren
authors.affiliation: Division of Neonatology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Palme-Kilander
authors.affiliation: Division of Neonatology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Annica
authors.initials: A
authors.lastname: Örtenstrand
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anna-Karin Edstedt
authors.initials: AK
authors.lastname: Bonamy
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Sachs' Children's Hospital, Stockholm, Sweden.
authors.forename: Ihsan
authors.initials: I
authors.lastname: Sarman
mesh_terms: D000328:Adult; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011247:Pregnancy; D012189:Retrospective Studies; D013548:Sweden
keywords: Epidemiology; Home visit; Neonatal care; Paediatrics; Preterm