Early Treatment Innovation for Opioid-Dependent Newborns: A Retrospective Comparison of Outcomes, Utilization, Quality, and Safety, 2006–2014

Abstract

Few coordinated treatment programs address the needs of infants and families struggling with the effects of substance use. In 2003 a large Southeastern regional hospital launched the Managing Abstinence in Newborns (MAiN) program, providing multidisciplinary, coordinated, community-based care for neonatal abstinence syndrome (NAS). A hypothesis-generating study was conducted to compare the outcomes of MAiN infants to comparable NAS infants receiving traditional care from 2006 through 2014 in South Carolina. De-identified sociodemographic and clinical data on MAiN infants, as well as NAS infants not treated with MAiN, were obtained from South Carolina statewide databases. Study measures included medical and safety outcomes, health services utilization, child protective services involvement, emergency services utilization, and inpatient readmissions. Some 110 infants were identified who received the MAiN intervention and 356 NAS infants, also in South Carolina, who were potentially MAiN eligible. Overall, there were no significant differences in the two groups regarding medical or safety outcomes or child protective services involvement. Traditional care NAS infants were more likely to be treated in a higher-level nursery (68.8% vs. 0%). MAiN infants had $8,204 less per birth in median charges (p <0.001) than the traditional care NAS infants. MAiN infants also had a lower percentage of ED visits (p = 0.01) assessed as possibly or likely NAS related compared to traditional care NAS infants. This study demonstrates the potential value of implementing the MAiN model in eligible NAS infants. With no difference in medical and safety outcomes and a significant reduction in charges, the MAiN model can be considered safe and cost-effective.