PDF(Pubmed)
Abstract：
Outpatient care following discharge from a neonatal intensive care unit (NICU) is critical for streamlined transfer of care. Yet, information is lacking about the characteristics of early outpatient care. The objective of this secondary data analysis is to describe outpatient encounters (OPEs) within the first three months following the discharge of commercially insured infants admitted to NICUs in the MarketScan Research Database nationally from 2015 to 2017. Data were analyzed using descriptive statistics and logistic regression. A total of 22,214 NICU survivors were included, of whom half had an OPE within two days following discharge (quartiles 1, 3) and 90% within five days. The median number of OPEs in the first three months was five (quartiles 4, 7). A majority of first physician visits were with pediatricians (81.5%). A minority of infants with chronic conditions saw subspecialists. Term infants with delayed care had a lower risk of readmission. Spending was higher for preterm infants and those with chronic conditions. We conclude that most patients are seen shortly after discharge and by pediatricians; however, there is room for improvement. Frequent encounters and spending afflict high-risk groups with chronic conditions. Future work should examine the associations of early outpatient care with social determinants of health and other outcomes such as immunizations.
摘要：
从新生儿重症监护病房（NICU）出院后的门诊护理对于简化护理转移至关重要。然而，缺乏有关早期门诊护理特征的信息。此二级数据分析的目的是描述2015年至2017年在全国MarketScan研究数据库中接受NICU的商业保险婴儿出院后的前三个月内的门诊遭遇（OPEs）。数据采用描述性统计和逻辑回归分析。总共包括22,214名NICU幸存者，其中一半在出院后两天内患有OPE（四分位数1，3），90%在五天内。前三个月的OPEs中位数为5（四分位数4、7）。大多数首次就诊的医生是儿科医生（81.5％）。少数患有慢性病的婴儿看到了专科医生。延迟护理的足月婴儿再次入院的风险较低。早产儿和慢性病患者的支出较高。我们得出的结论是，大多数患者在出院后不久和儿科医生就诊；然而，还有改进的余地。频繁的接触和支出困扰着慢性病的高危人群。未来的工作应检查早期门诊护理与健康和其他结果（例如免疫接种）的社会决定因素之间的关联。
