Abstract
BackgroundOur objectives were (1) to describe Care Transitions Measure (CTM) scores among caregivers of preterm infants after discharge from the neonatal intensive care unit (NICU) and (2) to describe the association of CTM scores with readmissions, enrollment in public assistance programs, and caregiver quality of life scores.MethodsThe study design was a cross-sectional study. We estimated adjusted associations between CTM scores (validated measure of transition) with outcomes using unconditional logistic and linear regression models and completed an E-value analysis on readmissions to quantify the minimum amount of unmeasured confounding.ResultsOne hundred sixty-nine parents answered the questionnaire (85% response rate). The majority of our sample was Hispanic (72.5%), non-English speaking (67.1%) and reported an annual income of <$20,000 (58%). Nearly 28% of the infants discharged from the NICU were readmitted within a year from discharge. After adjusting for confounders, we identified that a positive 10-point change of CTM score was associated with an odds ratio (95% CI) of 0.74 (0.58, 0.98) for readmission (p = 0.01), 1.02 (1, 1.05) for enrollment in early intervention, 1.03 (1, 1.05) for enrollment in food assistance programs, and a unit change (95% CI) 0.41 (0.27, 0.56) in the Multicultural Quality of Life Index score (p < 0.0001). The associated E-value for readmissions was 1.6 (CI 1.1) suggesting moderate confounding.ConclusionThe CTM may be a useful screening tool to predict certain outcomes for infants and their families after NICU discharge. However, further work must be done to identify unobserved confounding factors such as parenting confidence, problem-solving and patient activation.
Highlights
Our objectives were (1) to describe Care Transitions Measure (CTM) scores among caregivers of preterm infants after discharge from the neonatal intensive care unit (NICU) and (2) to describe the association of CTM scores with readmissions, enrollment in public assistance programs, and caregiver quality of life scores
After adjusting for race/ethnicity, post discharge diagnoses, use of medical equipment, maternal education, primary language, and neonatal co-morbidities, we identified that a positive 10-point change of CTM score was associated with an odds ratio of 0.74 (0.58, 0.98) for readmission (p = 0.01) (Table 2)
After adjusting for race/ethnicity, post discharge diagnoses, use of medical equipment, neonatal co-morbidities, and enrollment in early intervention, we identified that a positive 10-point change of CTM score was associated with an score change a unit change 0.41 (0.27, 0.56) in the Multicultural Quality of Life Index score (p < 0.0001) (Table 3)
Summary
Our objectives were (1) to describe Care Transitions Measure (CTM) scores among caregivers of preterm infants after discharge from the neonatal intensive care unit (NICU) and (2) to describe the association of CTM scores with readmissions, enrollment in public assistance programs, and caregiver quality of life scores. Ray et al have found an approximately 3-fold increase in risk of hospital readmission after discharge among premature infants compared to term infants. This increase in readmissions is inversely proportional to gestational age [2, 3, 6]. Post-discharge, premature infants have higher health care costs and utilization including frequent pediatric outpatient visits and prescription medications [8]. It has been estimated the average cost per readmission is approximately $8500 and the average annual total cost in excess ranging approximately $41–93 million [2]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
