Trends and challenges in United States neonatal intensive care units follow-up clinics

J Perinatol. 2014 Jan;34(1):71-4. doi: 10.1038/jp.2013.136. Epub 2013 Oct 31.

Abstract

Objective: A mandate exists that all level III neonatal intensive care units (NICUs) provide a means to assess and follow their high-risk neonates after discharge. However, no standardized guidelines exist for the follow-up services provided. To determine trends of structure and care provided in NICU follow-up clinics in both the academic and private clinical setting.

Study design: We sent an Internet survey to NICU follow-up clinic directors at both academically affiliated and private centers. This study received institutional review board exemption.

Result: We received 89 surveys from academic institutions and 94 from private level III follow-up programs. These responses represent 55% of academic programs and 40% of private programs in the United States. Similar to academic institutions, 18% of private NICU follow-up clinics provide primary care services to patients. In both settings, the hospital supports 60% of the funding required for clinic activities. Forty-five percent of NICU graduates seen in both private and academic follow-up clinics have public aid as their primary insurance. Eighty-five percent of NICUs in both settings have guidelines outlining requirements for referrals to the follow-up clinic. Academic programs find feeding difficulties the most difficult, whereas private programs find bronchopulmonary dysplasia and feeding difficulties equally as difficult.

Conclusion: The care and struggles of NICU follow-up clinics are similar in both the academic affiliated and private settings. Similar referrals, clinical evaluation and medical care occur with varying struggles.

MeSH terms

  • Continuity of Patient Care / organization & administration*
  • Continuity of Patient Care / trends
  • Health Care Surveys
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal / organization & administration*
  • Intensive Care Units, Neonatal / trends
  • United States