The use of health services in the first 2 years of life in a nationwide cohort of very preterm and/or very low birthweight infants in The Netherlands: rehospitalisation and out-patient care.

In a prospective collaborative survey on very preterm (less than 32 weeks) and/or very low birthweight (VLBW) infants (less than 1500 g) in The Netherlands, the use of health services was studied by examining the incidence of and reasons for rehospitalisation and the use of out-patient care, i.e. visits to medical specialists and physical therapists. Out of 1338 liveborn infants originally enrolled in the survey, 998 survived the initial hospital stay. Their use of health services was studied during four period: discharge-3 months, 3-6, 6-12 and 12-24 months corrected for expected date of delivery. A total of 320 infants (34%) was readmitted on 481 occasions. The main reasons for rehospitalisation were surgical procedures, of which inguinal herniorrhaphy was the most prominent, and respiratory tract disorders: 149 admissions (31%) and 147 (31%) admissions respectively. The remaining reasons for rehospitalisation occurred less frequently. In a multivariate analysis, both sex and the length of the initial hospital stay were shown to be significantly associated with an increased risk of rehospitalisation. During the study period, 671 children (67%) attended a medical specialist other than their paediatrician, and 313 children (31%) attended a physical therapist. The use of out-patient services was higher in the first than in the second year of follow-up. The use of health services depended very much on the neurodevelopmental status of the child. In the second year of life, a similar rehospitalisation rate and use of out-patient services was found in the non-impaired children as in children from the general Dutch population.