REPORTS FROM THE FIELD

Follow-up care reduces costs in high-risk infants

Outcomes also improve with follow-up

A program of comprehensive neonatal follow-up care after hospital discharge for inner-city high-risk infants reduces life-threatening illnesses and appears to reduce medical costs by more than $3,000 per infant, according to a study published in the Journal of the American Medical Association.

Researchers at the University of Texas Southwestern Medical Center at Dallas found that when high-risk infants received comprehensive follow-up care, 47% fewer of them died or developed life-threatening illnesses that required admission for pediatric intensive care. High-risk infants were defined as those weighing less than 1,000 g at birth or those weighing 1,001 to 1,500 g who required mechanical ventilation.

Comprehensive follow-up care for high-risk infants was defined as 24-hour access to highly experienced caregivers and five-day-a-week follow-up care, which included well-baby care, treatment for acute and chronic illnesses, and routine follow-up care. Routine follow-up care was available two days per week and included well-baby care and chronic illness management.

For all care between discharge and one year, the estimated average cost per infant was $6,265 for comprehensive care and $9,913 for routine care.

[See: Broyles RS, Tyson JE, Heyne ET, et al. Comprehensive follow-up care and life-threatening illnesses among high-risk infants: A randomized controlled trial. JAMA 2000; 284:2070-2076.]