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  • Original Article
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Pediatric care for preterm infants after NICU discharge: high number of office visits and prescription medications

Journal of Perinatology volume 28, pages 696–701 (2008)Cite this article

Abstract

Objective:

To determine the frequency and risk factors for clinic and pharmacy use in preterm infants during the first year after neonatal intensive care unit (NICU) discharge.

Study Design:

We analyzed clinic visits and prescriptions in a cohort of 23 to 32 weeks infants. We constructed multivariable regression models to determine risk factors for high use.

Result:

The 892 preterm infants experienced 18 346 pediatric visits (mean 20 visits per infant per year) and filled 2100 prescriptions (mean 5.5 prescriptions per year among infants taking medications). Most visits were non-well child care visits to pediatric primary care providers. Prematurity and bronchopulmonary dysplasia (BPD) are important risk factors: infants at 23 to 26 weeks gestation or infants with BPD had an average 29 visits per year and 9 prescriptions per year among infants taking medication. However, half of the highest using infants were relatively healthy infants at 27 to 32 weeks gestation who escaped BPD, NEC or grade 3 to 4 intraventricular hemorrhage.

Conclusion:

Premature infants had frequent pediatric visits and prescription medications. Extreme prematurity and neonatal morbidities are important risk factors; however, half of the highest using infants are moderately preterm without neonatal morbidities.

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Acknowledgements

We acknowledge the help of Marla Gardner and John D Greene for help with the creation of the data set, Joan Verdi for her assistance with developing the protocol, Orit Even-Shoshan for her oversight of the project and Karin McGowan, PhD, for her insightful comments on draft versions of this manuscript. This work was supported by a grant by the Maternal and Child Health Branch of the Health and Human Resources Services Administration Grant 1R40MC00236 (JHS).

Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

    K C Wade & S A Lorch

  2. Center for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

    S A Lorch & J H Silber

  3. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA

    S A Lorch & J H Silber

  4. School of Nursing, Health and Exercise Science, The College of New Jersey, Ewing, NJ, USA

    S Bakewell-Sachs

  5. School of Nursing, University of Pennsylvania, Philadelphia, PA, USA

    B Medoff-Cooper

  6. Department of Pediatrics and Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

    J H Silber

  7. Division of Research, Northern California Kaiser Permanente Medical Program, Oakland, CA, USA

    G J Escobar

  8. Division of Inpatient Pediatrics, Kaiser Permanente Medical Program, Walnut Creek, CA, USA

    G J Escobar

Authors
  1. K C Wade
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  2. S A Lorch
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  3. S Bakewell-Sachs
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  4. B Medoff-Cooper
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  5. J H Silber
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  6. G J Escobar
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Correspondence to K C Wade.

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Wade, K., Lorch, S., Bakewell-Sachs, S. et al. Pediatric care for preterm infants after NICU discharge: high number of office visits and prescription medications. J Perinatol 28, 696–701 (2008). https://doi.org/10.1038/jp.2008.74

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  • DOI: https://doi.org/10.1038/jp.2008.74

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