Post-discharge healthcare utilization in infants with neonatal opioid withdrawal syndrome.
Adult
Aftercare
Cohort Studies
Databases, Factual
Emergency Medical Services
/ statistics & numerical data
Female
Hospitalization
/ statistics & numerical data
Humans
Infant, Newborn
International Classification of Diseases
Length of Stay
Male
Neonatal Abstinence Syndrome
/ drug therapy
Patient Acceptance of Health Care
Patient Discharge
Patient Readmission
/ statistics & numerical data
Pregnancy
Retrospective Studies
Healthcare utilization
Hospitalizations
Infants
Neonatal opioid withdrawal syndrome
Opioids
Pregnancy
Journal
Neurotoxicology and teratology
ISSN: 1872-9738
Titre abrégé: Neurotoxicol Teratol
Pays: United States
ID NLM: 8709538
Informations de publication
Date de publication:
Historique:
received:
16
11
2020
revised:
10
03
2021
accepted:
15
03
2021
pubmed:
27
3
2021
medline:
18
1
2022
entrez:
26
3
2021
Statut:
ppublish
Résumé
The opioid epidemic in the United States has led to a significant increase in the incidence of neonatal opioid withdrawal syndrome (NOWS); however, the understanding of long-term consequences of NOWS is limited. The objective of this study was to evaluate post-discharge healthcare utilization in infants with NOWS and examine the association between NOWS severity and healthcare utilization. A retrospective cohort design was used to ascertain healthcare utilization in the first year after birth-related discharge using the CERNER Health Facts® database. ICD-9/ICD-10 diagnostic codes were used to identify live births and to classify infants into two study groups: NOWS and uncomplicated births (a 25% random sample). Evaluated outcomes included rehospitalization, emergency department (ED) visits within 30-days and one-year after discharge, and a composite one-year utilization event (either hospitalization or emergency department visit during that year). NOWS severity was operationalized as pharmacologic treatment, length of hospitalization, and medical conditions often associated with NOWS. In 3,526 infants with NOWS (restricted to gestational age ≥ 33 weeks), NOWS severity was associated with an increase in composite one-year utilization (OR: 1.1; 95% CI: 1.04-1.2) after adjusting for prematurity, sepsis, jaundice, use of antibiotics, infant sex, insurance status, race, hospital bed size, year of birth, and census division. In a subset of full-term infants (3008 with NOWS and 88,452 uncomplicated births), having a NOWS diagnosis was associated with higher odds of a 30-day (OR: 1.6; 95% CI: 1.03-2.4) and one-year rehospitalization (OR: 1.6; 95% CI: 1.1-2.4) after adjusting for infant sex, race, type of medical insurance, hospital location, census division, year of primary encounter, hospital bed size, and medical conditions. This study found higher healthcare utilization during the first year of life in infants diagnosed with NOWS, especially those with severe NOWS. Findings suggest a need for closer post-discharge follow-up and management of infants with NOWS.
Identifiants
pubmed: 33766722
pii: S0892-0362(21)00029-5
doi: 10.1016/j.ntt.2021.106975
pmc: PMC8277706
mid: NIHMS1689232
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
106975Subventions
Organisme : NIDA NIH HHS
ID : R34 DA050237
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001449
Pays : United States
Organisme : NCATS NIH HHS
ID : TL1 TR000449
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002345
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA021771
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
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