Primary care follow-up among children born with neonatal abstinence syndrome in a rural region in the United States

IF 0.8 Q4 NURSING
Stephiya Sabu, Abby Hodges, Cierra Buckman, Dmitry Tumin, Shaundreal Jamison
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引用次数: 1

Abstract

Introduction Children born with neonatal abstinence syndrome (NAS) have lower rates of preventive care utilization than children born without NAS, a pattern which is only partially explained by differences in social determinants of health (SDH). We sought to determine whether SDH and clinical characteristics were associated with well-child visit (WCV) attendance among children born with NAS in a rural academic health system. Methods Infants born at a single hospital in 2016–2018 were retrospectively included if they were diagnosed with non-iatrogenic NAS attributable to in utero opioid exposure and established care with an affiliated primary care clinic by 6 months of age. Healthcare utilization was tracked through the first 12 months of life. Independent variables included demographics, prenatal risk factors, insurance coverage, and SDH such as housing problems and food insecurity. Ages and Stages Questionnaire (ASQ) scores were extracted from the latest completed WCV during the first year of life. Results We identified 182 patients with NAS, of whom 80 established care with the primary care clinic, with a median of four WCVs (interquartile range: 2, 5) completed by 12 months of age. On unadjusted Poisson regression, none of the demographic, clinical, or SDH characteristics were associated with the number of completed WCVs. Among 44 patients with available ASQ data, the number of WCVs was not associated with ASQ scores at the latest WCV. Conclusions Within an academic rural health system, SDH and other infant or family characteristics did not predict WCV attendance among infants with NAS.
美国农村地区新生儿戒断综合征患儿的初级保健随访
出生时患有新生儿戒断综合征(NAS)的儿童比出生时没有戒断综合征的儿童有更低的预防保健使用率,这种模式只能部分地解释为健康的社会决定因素(SDH)的差异。我们试图确定SDH和临床特征是否与农村学术卫生系统中出生时患有NAS的儿童的儿童访视(WCV)出勤有关。方法回顾性纳入2016-2018年在一家医院出生的婴儿,如果他们被诊断为非医源性NAS,可归因于子宫内阿片类药物暴露,并在6个月大的附属初级保健诊所进行了既定护理。在出生后的前12个月,对医疗保健利用情况进行了跟踪。独立变量包括人口统计、产前风险因素、保险覆盖率和SDH,如住房问题和粮食不安全。年龄和阶段问卷(ASQ)得分从生命第一年最新完成的WCV中提取。结果:我们确定了182例NAS患者,其中80例在初级保健诊所进行了治疗,在12个月大时完成了中位4次wcv(四分位数范围:2,5)。在未经调整的泊松回归中,人口统计学、临床或SDH特征与完成wcv的数量无关。在44例可获得ASQ数据的患者中,WCV的数量与最新WCV的ASQ评分无关。结论:在农村学术卫生系统中,SDH和其他婴儿或家庭特征不能预测NAS婴儿的WCV出勤率。
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来源期刊
CiteScore
3.10
自引率
14.30%
发文量
15
期刊介绍: The International Journal of Care Coordination (formerly published as the International Journal of Care Pathways) provides an international forum for the latest scientific research in care coordination. The Journal publishes peer-reviewed original articles which describe basic research to a multidisciplinary field as well as other broader approaches and strategies hypothesized to improve care coordination. The Journal offers insightful overviews and reflections on innovation, underlying issues, and thought provoking opinion pieces in related fields. Articles from multidisciplinary fields are welcomed from leading health care academics and policy-makers. Published articles types include original research, reviews, guidelines papers, book reviews, and news items.
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