Neurodevelopmental Care Utilization among Preterm Infants in the Military Health Care System.

Abstract

Objective: This study aims to evaluate variation in neurodevelopmental care utilization in the Military Health System (MHS) for preterm infants.

Study design: Retrospective cohort study of infants born preterm within the MHS from 2017 to 2021. Preterm birth was categorized as extreme preterm, very preterm, moderate preterm, late preterm, or unknown. Patient demographics were extracted. The primary outcome was the use of neurodevelopmental care within 2 years of birth.

Results: Compared with late preterm births, total use of specialty care was significantly higher (p < 0.05) in moderate, very, and extreme preterm births. Black infants had fewer total visits than White infants (-1.54, p < 0.05). Disparities by region of birth were noted, with lower utilization in the Pacific and West South-Central census divisions (p < 0.05).

Conclusion: There are differences in neurodevelopmental care utilization among preterm infants in the MHS, driven by gestational age, race, and geography. These findings support the need for a standardized policy on neurodevelopmental follow-up.

Key points: · Neurodevelopmental utilization varies by sociodemographic factors.. · Despite universal access to care, neurodevelopmental care utilization varies in the military health care system.. · Standardized neurodevelopmental follow-up is needed to ensure equitable access to care..