Health care use outcomes of an integrated hospital-to-home mother-preterm infant intervention

Abstract

Objective To compare health care use from initial hospital discharge through 6 weeks corrected age in two groups of mother-preterm infant dyads: those who received an intervention, Hospital to Home: Optimizing Premature Infant's Environment (H-HOPE), and an attention control group. Design Prospective randomized controlled trial. Setting Two community hospital NICUs. Participants Mothers (n = 147) with social-environmental risk factors and their stable preterm infants. Methods Mother-infant dyads were randomly assigned to the H-HOPE or control group. When infants reached 6 weeks corrected age, information about health care visits since their hospital discharges was collected through an interview. Results Only half of all infants received all recommended well-child visits. Infants in H-HOPE were half as likely to have acute care episodes (illness visit to the clinic or emergency department or hospital readmission) as control infants (odds ratio [OR] = 0.46, 95% confidence interval [CI] [0.22, 0.95]). Infants of mothers with high trait anxiety were nearly 3 times more likely to have an acute care episode (OR = 2.78, 95% CI [1.05, 7.26]), and mothers who had low education levels (OR = .22, 95% CI [0.08, 0.60]) were less likely to have acute care episodes. There was a trend toward fewer acute care visits for infants whose mothers preferred an English interview (OR = .47, 95% CI [0.21, 1.06]). Conclusion Findings emphasize the importance of reinforcing well-child visits for vulnera…