Are Outcomes and Care Processes for Preterm Neonates Influenced by Health Insurance Status

作者: G. D. Brandon , S. Adeniyi-Jones , S. Kirkby , D. Webb , J. F. Culhane

DOI: 10.1542/PEDS.2008-1318

关键词:

摘要: OBJECTIVE: The purpose ofthis work was to compare the processes of care and evaluate outcomes premature neonates delivered women with Medicaid managed versus private insurance. DESIGN/METHODS: All infants born at <37 weeks' gestation between January 2001 August 2005 in ParadigmHealth database were included these analyses (n = 24 151). Infants categorized by maternal health insurance status as or analyzed for differences demographic data length stay. For survivors, respiratory care, nutritional, maturational milestones assessed. In addition, age wean open crib, weight gain, home oxygen, apnea monitor use compared. Adverse outcomes, including necrotizing enterocolitis, sepsis, severe intraventricular hemorrhage, retinopathy prematurity, bronchopulmonary dysplasia, apnea, mortality, Statistical tests used Students t test, χ 2 , Kruskall-Wallis test. Multiple logistic regression performed after controlling variables. RESULTS: Of 151 studied, 19 046 (78.9%) had insurance, 5105 (21.1%) care. There no gestational birth; however, lower birth weight, Apgar score 5 minutes, increased incidence enterocolitis bacterial longer surviving infants, more went on oxygen monitors despite found incidences dysplasia groups. feeding milestones, but weaned an crib later greater overall gain compared CONCLUSIONS: We speculate that, addition known impact well-being birth, is independently associated adverse neonatal preterm well intensive discharge processes.

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