Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
St. Louis Children's Hospital, St. Louis, MO, USA.
Acta Paediatr. 2021 May;110(5):1468-1474. doi: 10.1111/apa.15700. Epub 2020 Dec 12.
Early therapy can improve developmental outcomes for preterm infants. However, preterm infants who are referred have low enrolment in early therapy services following neonatal intensive care unit (NICU) discharge. This manuscript aims to investigate the relationship between infant medical and sociodemographic factors and enrolment in early therapy services post-NICU discharge, when system-related barriers to access are minimised.
This was a retrospective investigation of 89 families with infants born ≤32 weeks of gestation. Families were approached for enrolment into early therapy services following NICU discharge through Baby Bridge programming, which aims to improve access to therapy services following NICU discharge.
Seventy-three (82%) families enrolled in early therapy services, and 16 (18%) families declined. Parents were more likely to enrol in early therapy if they had public insurance (P = 0.01), a maternal psychiatric diagnosis (P = 0.02) or additional children under 18 years in the home (P = 0.01). No infant medical factors were related to enrolment.
Although enrolment rates were high, 18% of families refused therapy services, despite removing system-related barriers to access. Targeted interventions can be developed to increase enrolment in early therapy services among populations who are most likely to refuse therapy services after NICU discharge.
早期治疗可以改善早产儿的发育结果。然而,在新生儿重症监护病房(NICU)出院后,被转介的早产儿接受早期治疗服务的比例较低。本文旨在研究婴儿医疗和社会人口因素与 NICU 出院后接受早期治疗服务之间的关系,此时与系统相关的获取障碍最小化。
这是一项对 89 个出生胎龄≤32 周的婴儿家庭的回顾性研究。通过婴儿桥计划(Baby Bridge program)在 NICU 出院后为家庭提供早期治疗服务的登记,该计划旨在改善 NICU 出院后获得治疗服务的机会。
73 个(82%)家庭登记参加了早期治疗服务,16 个(18%)家庭拒绝参加。如果父母有公共保险(P=0.01)、产妇有精神科诊断(P=0.02)或家中有 18 岁以下的其他孩子,他们更有可能参加早期治疗。没有婴儿医疗因素与登记有关。
尽管登记率很高,但仍有 18%的家庭拒绝接受治疗服务,尽管已经消除了与系统相关的获取障碍。可以制定有针对性的干预措施,以增加 NICU 出院后最有可能拒绝治疗服务的人群接受早期治疗服务的比例。