To compare health care use from neonatal discharge to 18 months corrected age of two groups of extremely preterm children (< 26 vs. 26-29 weeks of gestation), we used a province-wide database containing neonatal and follow-up data on 254 infants (77% of survivors) born at < 29 weeks of gestation and cared for at 3/6 neonatal units in Quebec in 2003-2004. Neonatal data were abstracted from medical records by trained personnel. At 18 months corrected age, neurodevelopmental status was assessed by psychologists and paediatricians. Data on health care use were collected from charts and parent interviews. Descriptive statistics are provided and logistic regression analysis was carried out to evaluate perinatal and social determinants of re-hospitalization and frequent use of health services resources. Results show that 57% of infants born at < 26 weeks (n=49) and 49% of those born at 26-29 weeks (n=205) were re-hospitalized, mostly for respiratory illness. Both groups used a significant amount of health resources: 61% vs. 59%, respectively, received physical or occupational therapy, 29% vs. 17%, respectively, required long-term rehabilitation, 38% vs. 28%, respectively, used prescribed medication, and 59% vs. 33%, respectively, required home medical equipment (home oxygen, apnea monitors, orthopaedic devices and visual aids). Risk of re-hospitalization was associated with severe brain injury, use of an apnea monitor, and older age at neonatal discharge. Multiple birth, severe brain injury, suspected neonatal sepsis, and single-parent household were independently associated with the risk of using health care services above average. These results highlight the importance of resource allocation to preterm infants for medical and rehabilitation services after discharge from the neonatal intensive care unit.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.116120 |
| Date | January 2008 |
| Creators | Luu, Thuy-Mai. |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 003134621, proquestno: AAIMR67065, Theses scanned by UMI/ProQuest. |
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