Work

Impact of Longitudinal Care Coordination on Medically Complex Infant Outcomes in a Level IV Neonatal Intensive Care Unit

Year: 2025

Type: article

Abstract: OBJECTIVE Evaluate the impact of a level IV neonatal intensive care unit (NICU) longitudinal care coordination program (LCCP) for medically complex infants on resource utilization outcomes. METHODS We conducted a longitudinal observational study of 95 infants admitted to a level IV NICU and enrolled in a new LCCP from 2018 to 2021. Two-year survival and follow-up rates were compared with a historical cohort of 96 NICU patients admitted the year prior to program initiation. To assess enrollment efficiency over time, data were compared across three 1-year epochs. Comprehensive data were collected to assess changes in (1) hospital length of stay and (2) efficiency in time to program enrollment, and identification of patients with highest complexity of medical and social needs. Secondary outcomes included (1) survival after discharge and (2) compliance with outpatient follow-up. RESULTS As compared with the preprogram cohort, LCCP-enrolled patients were more medically complex, with lower median gestational age and birth weight and a higher degree of organ system involvement and subspecialty consultations. LCCP families were more likely to have significant health literacy concerns (27% vs 2%; P < .001). Over the 3-year period, time to enrollment became more efficient. LCCP patients had longer length of hospitalization; however, follow-up rates were higher in the LCCP group (0% lost to follow-up) with significantly improved 2-year survival (86% vs 76%; P < .001). CONCLUSIONS The program identified more medically complex patients, with increased efficiency over time and improved survival and outpatient follow-up after discharge. LCCP may be a transferable model for medically complex infants.

Source: Pediatrics Open Science

DOI: 10.1542/pedsos.2024-000228

Authors: Stephannie Voller, Maria L.V. Dizon’s, Nana Matoba, Alexandra A. Ryan, Karen K. Mestan

Institutions: Northwestern University, Lurie Children's Hospital, University of California San Diego, Rady Children's Hospital-San Diego

Language: English

Topic: Infant Development and Preterm Care

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Northwestern University