Mingyan Hei1, Xiangyu Gao2, Ying Li3, Xirong Gao4, Zhankui Li5, Shiwen Xia6, Qianshen Zhang7, Shuping Han8, Hongxia Gao9, Shaohan Nong10, Aimin Zhang11, Jia Li12, Yanchen Wang13, Xiang Y Ye14, Shoo K Lee15. 1. Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China; National Center of Children's Health, Beijing, China. Electronic address: heimingyan@bch.com.cn. 2. Department of Pediatrics, Southeast University Affiliated Xuzhou Hospital, Xuzhou, Jiangsu, China. 3. Department of Pediatrics, Third Xiangya Hospital of Central South University, Changsha, Hunan, China. 4. Department of Neonatology, Hunan Children's Hospital, Changsha, Hunan, China. 5. Department of Neonatology, Northwest Women and Children's Hospital, Xi'an, Shaanxi, China. 6. Department of Neonatology, Hubei Province Women and Children Hospital, Wuhan, Hubei, China. 7. Department of Neonatology, Shenzhen Maternal and Childcare Hospital, Shenzhen, Guangdong, China. 8. Department of Neonatology, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China. 9. Department of Neonatology, Gansu Provincial Maternity and Childcare Hospital, Lanzhou, Gansu, China. 10. Department of Pediatrics, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China. 11. Department of Neonatology, Hunan Provincial People's Hospital, Changsha, Hunan, China. 12. Department of Neonatology, Kunming Maternal and Child Healthcare Hospital, Kunming, Yunnan, China. 13. Chinese Neonatal Network, Fudan Children's Hospital, Shanghai, China. 14. Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. 15. Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: To explore whether family integrated care (FICare) is feasible and improves the outcomes of preterm infants in China. STUDY DESIGN: This was a multicenter prospective cluster-randomized controlled trial comparing FICare and standard care. The primary outcome was length of stay (LOS). Secondary outcomes were nosocomial infections, duration of supplemental oxygen, breastfeeding, and weight gain. Outcomes were compared using univariate and multivariable analyses adjusted for potential confounders and clustering. RESULTS: We enrolled 601 preterm infants from 11 neonatal intensive care units (FICare, n = 298; control, n = 303). The unadjusted LOS was 30.81 vs 30.26 days (mean ratio, 1.02; 95% CI, 0.85-1.22; P = .85). After adjustment, outcomes in the FICare group were improved compared with the control group, including LOS (28.26 vs 35.04 days; mean ratio, 0.81; 95% CI, 0.72-0.91), total medical expenditures (mean ratio, 0.69; 95% CI, 0.53-0.90), weight gain velocity (15.73 vs 10.30 g/day; mean difference, 5.43; 95% CI, 3.65-7.21), duration of supplemental oxygen (13.11 vs 21.42 days; mean difference, 0.71; 95% CI, 0.50-1.00), nosocomial infection rates (4.13 vs 5.84/1000 hospital days; mean ratio, 0.67; 95% CI, 0.47-0.96), antibiotic exposure (38.63 vs 57.32/100 hospital days; mean ratio, 0.67; 95% CI, 0.47-0.96), breastfeeding rates (87.25% vs 55.78%; OR, 5.42; 95% CI, 3.25-9.05), and rehospitalization rates (3.65% vs 7.48%; OR, 0.47; 95% CI, 0.28-0.77). At follow-up to 18 months, breastfeeding rates and weight were significantly (P < .05) higher over time in the FICare group. CONCLUSIONS:FICare was feasible in Chinese neonatal intensive care units and was associated with reduced hospital LOS, medical expenditures, and rates of adverse outcomes.
RCT Entities:
OBJECTIVE: To explore whether family integrated care (FICare) is feasible and improves the outcomes of preterm infants in China. STUDY DESIGN: This was a multicenter prospective cluster-randomized controlled trial comparing FICare and standard care. The primary outcome was length of stay (LOS). Secondary outcomes were nosocomial infections, duration of supplemental oxygen, breastfeeding, and weight gain. Outcomes were compared using univariate and multivariable analyses adjusted for potential confounders and clustering. RESULTS: We enrolled 601 preterm infants from 11 neonatal intensive care units (FICare, n = 298; control, n = 303). The unadjusted LOS was 30.81 vs 30.26 days (mean ratio, 1.02; 95% CI, 0.85-1.22; P = .85). After adjustment, outcomes in the FICare group were improved compared with the control group, including LOS (28.26 vs 35.04 days; mean ratio, 0.81; 95% CI, 0.72-0.91), total medical expenditures (mean ratio, 0.69; 95% CI, 0.53-0.90), weight gain velocity (15.73 vs 10.30 g/day; mean difference, 5.43; 95% CI, 3.65-7.21), duration of supplemental oxygen (13.11 vs 21.42 days; mean difference, 0.71; 95% CI, 0.50-1.00), nosocomial infection rates (4.13 vs 5.84/1000 hospital days; mean ratio, 0.67; 95% CI, 0.47-0.96), antibiotic exposure (38.63 vs 57.32/100 hospital days; mean ratio, 0.67; 95% CI, 0.47-0.96), breastfeeding rates (87.25% vs 55.78%; OR, 5.42; 95% CI, 3.25-9.05), and rehospitalization rates (3.65% vs 7.48%; OR, 0.47; 95% CI, 0.28-0.77). At follow-up to 18 months, breastfeeding rates and weight were significantly (P < .05) higher over time in the FICare group. CONCLUSIONS: FICare was feasible in Chinese neonatal intensive care units and was associated with reduced hospital LOS, medical expenditures, and rates of adverse outcomes.
Authors: Anna Reiter; Julie De Meulemeester; Nathan Kenya-Mugisha; Abner Tagoola; Olive Kabajaasi; Matthew O Wiens; Jessica Duby Journal: Front Pediatr Date: 2022-08-25 Impact factor: 3.569
Authors: Bárbara Moreno-Sanz; María Teresa Montes; Marta Antón; María Teresa Serrada; Marta Cabrera; Adelina Pellicer Journal: Front Pediatr Date: 2021-06-09 Impact factor: 3.418