Effect of Health Insurance Status and Visitation Restrictions on Virtual Visitation Technology in the Neonatal Intensive Care Unit.

Abstract

To examine the relationship between virtual technology system utilization and insurance status or type of visitation restrictions in a single center neonatal intensive care unit. Prospective cohort study with separate analyses performed based on insurance status (public versus non-public) and "in effect" unit visitation restrictions. The three study epochs based on patient visitation restrictions were epoch 1 (July to October 2019) with standard visitation restrictions, epoch 2 (November 2019 to February 2020) with RSV/Influenza visitation restrictions, and epoch 3 (March to June 2020) with COVID-19 visitation restrictions, respectively. Families of 357 infants used web-based cameras through most of the infant's hospitalization (median 86.05%, Q3 97.9%) with 165,795 total camera logins, indicating consistent utilization. There was a trend for fewer logins per infant and significantly longer time to consent (p=0.03) in the Public Insurance group. Unit visitation restrictions impacted the time to consent, the shortest being in Epoch 3 during the Covid-19 pandemic (p=0.03). Virtual visitation technology is well embraced by NICU families, however gaps in access and use among subgroups signals a form of social inequality that needs to be explored further.