Rehospitalization of extremely low birth weight (ELBW) infants: Are there racial/ethnic disparities?

被引：58

作者：

Morris B.H. ^{[1
,14
]}

Gard C.C. ^{[3
]}

Kennedy K. ^{[1
,2
]}

Vohr B. ^{[4
]}

Wilson-Costello D. ^{[5
]}

Steichen J. ^{[6
]}

Simon N. ^{[7
]}

Stoll B. ^{[7
]}

Dusick A. ^{[8
]}

Bauer C. ^{[9
]}

Papile L.A. ^{[10
]}

Hintz S. ^{[11
]}

Bada H. ^{[12
]}

Broyles S. ^{[13
]}

Delaney-Black V. ^{[15
]}

Johnson Y. ^{[15
]}

Ehrenkranz R. ^{[16
]}

机构：

[1] Department of Paediatrics, University of Texas Medical School at Houston, Houston, TX 77030

[2] Center for Clinical Research and Evidence Based Medicine, University of Texas Medical School at Houston, Houston, TX 77030

[3] RTI International, Rockville, MD

[4] Brown University, Providence, RI

[5] Case Western Reserve University, Cleveland, OH

[6] University of Cincinnati, Cincinnati, OH

[7] Emory University, Atlanta, GA

[8] Indiana University, Bloomington, IN

[9] University of Miami, Miami, FL

[10] University of New Mexico, Albuquerque, NM

[11] Stanford University, Stanford, CA

[12] University of Tennessee, Memphis, TN

[13] University of Texas Southwestern at Dallas, Dallas, TX

[14] University of Texas at Houston, Houston, TX

[15] Wayne State University, Detroit, MI

[16] Yale University, New Haven, CT

来源：

Journal of Perinatology | 2005年 / 25卷 / 10期

关键词：

D O I：

10.1038/sj.jp.7211361

中图分类号：

学科分类号：

摘要：

Background: Premature infants are at increased risk for rehospitalization after discharge from the hospital. Racial disparities are known to exist in pediatric health care. Objective: To evaluate whether racial disparities exist in the proportion of extremely low birth weight (ELBW) infants rehospitalized prior to 18 months corrected age and the causes of rehospitalization. Methods: The National Institute of Child Health and Human Development Neonatal Research Network database was used to identify all ELBW infants (n=2446) who were born between November 1, 1998 and May 31, 2000 at the 14 participating centers and discharged alive (n=1591). Infants were seen at 18 -22 months corrected age for followup. Data related to maternal variables, race, socioeconomic status, medical morbidities, insurance, and rehospitalizations were recorded from the medical record and parent interview. Logistic regression analyses were used to examine the relationship of race/ethnicity and rehospitalization while controlling for gestational age, gender, center, maternal education, family income, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, ventriculoperitoneal (VP) shunt, respiratory syncytial virus (RSV) prophylaxis, and insurance type. Results: In all, 1405 (88%) infants were evaluated at followup. The racial distribution of infants admitted, discharged, seen at followup, and rehospitalized were similar. Rehospitalization occurred at least once in 49% of the infants. In the logistic regression analyses, race was not a significant predictor for rehospitalization. The odds of rehospitalization were related to low family income, type of insurance, BPD, VP shunt, RSV prophylaxis, and center. Conclusion: Race was not a predominant variable in the risk of rehospitalization in this cohort of ELBW infants. Medical morbidities and low family income appear to be the major risk factors for rehospitalization. © 2005 Nature Publishing Group. All rights reserved.

引用

页码：656 / 663

页数：7

共 32 条

[1]

Hack M., DeMonterice D., Merkatz I.R., Jones P., Fanaroff A.A., Rehospitalization of the very low-birth-weight infant, Am. J. Dis. Child, 135, pp. 263-266, (1981)

[2]

Furman L., Baley J., Borawski-Clark E., Aucott S., Hack M., Hospitalization as a measure of morbidity among very low birth weight infants with chronic lung disease, J. Pediatr., 128, pp. 447-452, (1996)

[3]

Shattuck K.E., Abu-Ghosh A.M., Wildin S.R., Landry S.H., Smith K.E., Respiratory morbidity in three year old children born preterm, Neonatal Intens. Care, 11, pp. 11-15, (1998)

[4]

Stevens G.D., Shi L., Racial and ethnic disparities in the primary care experience of children: A review of the literature, Med. Care Res. Rev., 60, pp. 3-30, (2003)

[5]

Singh G.K., Yu S.M., Infant mortality in the United States: Trends, differentials, and projections, 1950-2010, Am. J. Public Health, 85, pp. 957-964, (1995)

[6]

Demissie K., Rhoads G.G., Ananth C.V., Et al., Trends in preterm birth and neonatal mortality among blacks and whites in the United States from 1989 to 1997, Am. J. Epidemiol., 154, pp. 307-315, (2001)

[7]

Papacek E.M., Collins J.W., Schulte N.F., Goergen C., Drolet A., Differing postneonatal mortality rates of African American and white infants in Chicago: An ecologic study, Matern. Child Health J., 6, pp. 99-105, (2002)

[8]

Hahn B.A., Racial and ethnic differences in the use of prescription medications, Pediatrics, 95, pp. 727-732, (1995)

[9]

Park C.H., Kogan M.D., Overpeck M.D., Casselbrant M.L., Black-White differences in health care utilization among US children with frequent ear infections, Pediatrics, 109, 5, (2002)

[10]

McCormick M.C., Shapiro S., Starfield B.H., Rehospitalization in the first year of life for high risk survivors, Pediatrics, 66, pp. 991-999, (1980)

← 1 2 3 4 →