Vidya V Pai1, Peiyi Kan2,3, Tianyao Lu2,4, Erika E Gray2,4, Mihoko Bennett2,3, Maria A L Jocson5, Henry C Lee2,3, Suzan L Carmichael2,6,7, Susan R Hintz2,4. 1. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford School of Medicine, Stanford, CA, USA. vidyavpai@gmail.com. 2. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford School of Medicine, Stanford, CA, USA. 3. California Perinatal Quality Care Collaborative, Stanford, CA, USA. 4. California Perinatal Quality Care Collaborative-California Children's Services High Risk Infant Follow-Up Quality of Care Initiative, San Francisco, CA, USA. 5. Department of Health Care Services, Integrated Systems of Care, California Children's Services, San Francisco, CA, USA. 6. Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA, USA. 7. Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford School of Medicine, Stanford, CA, USA.
Abstract
OBJECTIVE: To determine the rates of high-risk infant follow-up (HRIF) attendance and the characteristics associated with follow-up among infants with hypoxic-ischemic encephalopathy (HIE) in California. STUDY DESIGN: Using population-based datasets, 1314 infants with HIE born in 2010-2016 were evaluated. The characteristics associated with follow-up were identified through multivariable logistic regression. RESULTS: 73.9% of infants attended HRIF by age 1. Follow-up rates increased and variation in follow-up by clinic decreased over time. Female infants; those born to African-American, single, less than college-educated, or publicly insured caregivers; and those referred to high-volume or regional programs had lower follow-up rates. In multivariable analysis, Asian and Pacific Islander race/ethnicity had lower odds of follow-up; infants with college- or graduate school-educated caregivers or referred to mid-volume HRIF programs had greater odds. CONCLUSION: Sociodemographic and program-level characteristics were associated with lack of follow-up among HIE infants. Understanding these characteristics may improve the post-discharge care of HIE infants.
OBJECTIVE: To determine the rates of high-risk infant follow-up (HRIF) attendance and the characteristics associated with follow-up among infants with hypoxic-ischemic encephalopathy (HIE) in California. STUDY DESIGN: Using population-based datasets, 1314 infants with HIE born in 2010-2016 were evaluated. The characteristics associated with follow-up were identified through multivariable logistic regression. RESULTS: 73.9% of infants attended HRIF by age 1. Follow-up rates increased and variation in follow-up by clinic decreased over time. Female infants; those born to African-American, single, less than college-educated, or publicly insured caregivers; and those referred to high-volume or regional programs had lower follow-up rates. In multivariable analysis, Asian and Pacific Islander race/ethnicity had lower odds of follow-up; infants with college- or graduate school-educated caregivers or referred to mid-volume HRIF programs had greater odds. CONCLUSION: Sociodemographic and program-level characteristics were associated with lack of follow-up among HIE infants. Understanding these characteristics may improve the post-discharge care of HIE infants.
Authors: Namasivayam Ambalavanan; Seetha Shankaran; Abbot R Laptook; Benjamin A Carper; Abhik Das; Waldemar A Carlo; C Michael Cotten; Andrea F Duncan; Rosemary D Higgins Journal: Pediatrics Date: 2021-05-13 Impact factor: 9.703