Kang Kyoung Yee, Kang Eun Sil, Park Hye-Kang, Hong Seung Been, Lee Ha Lim
Department of Children's Rehabilitation, Public Children's Rehabilitation Hospital, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Republic of Korea.
Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
PLoS One. 2025 May 9;20(5):e0322998. doi: 10.1371/journal.pone.0322998. eCollection 2025.
There is growing recognition of the importance of rehabilitation through immediate and long-term follow-up, and neonatal intensive care unit (NICU) aftercare is emerging as an important field to consider rehabilitation services. An increasing number of children born are admitted to the NICU with complications commonly related to low birth weight, premature birth, and development of underlying diseases. Early initiation of rehabilitation services in the NICU has become more common and includes therapies relating to feeding tube removal and pulmonary breathing. We investigated the patterns of rehabilitation utilization (rehabilitation frequency, moving to an area for rehabilitation treatment) and medical expenses based on NICU hospitalization history. Data from the Korean National Health Insurance Service Database over a span of ten years were reviewed, with an observation period of 3 years after the first rehabilitation session. The newborns were divided into two groups: 16,626 in the NICU group and the non-NICU group, matched 1:1 based on NICU hospitalization history. The number of rehabilitation treatments in the non-NICU group was significantly higher over the two years following the initial rehabilitation session (p < 0.05). In contrast, the total medical expenses during the 6 months following the initial rehabilitation session were more than six times higher in the NICU group (KRW 1,868,516 vs. 11,348,940, p < 0.0001). The NICU group showed significantly more discrepancies between their residence and the first rehabilitation treatment area (9.5% vs. 13.4%, p < 0.001). Results indicate that the amount of rehabilitation sessions and access to rehabilitation for individuals with a NICU history is lower compared to those without a NICU history. Therefore, national support is needed to revitalize rehabilitation procedures and reduce medical expenses in the NICU group, and further studies should focus on novel methods to revitalize NICU rehabilitation.
人们越来越认识到通过即时和长期随访进行康复的重要性，新生儿重症监护病房（NICU）的后续护理正成为考虑康复服务的一个重要领域。越来越多出生的儿童因与低出生体重、早产和潜在疾病发展相关的常见并发症而入住NICU。在NICU中早期启动康复服务变得更加普遍，包括与拔除喂食管和肺部呼吸相关的治疗。我们基于NICU住院病史调查了康复利用模式（康复频率、转至康复治疗区域）和医疗费用。回顾了韩国国民健康保险服务数据库十年期间的数据，首次康复治疗后有3年的观察期。新生儿被分为两组：NICU组16,626例和非NICU组，根据NICU住院病史1:1匹配。在首次康复治疗后的两年中，非NICU组的康复治疗次数显著更高（p < 0.05）。相比之下，首次康复治疗后6个月内NICU组的总医疗费用高出六倍多（1,868,516韩元对11,348,940韩元，p < 0.0001）。NICU组在其居住地和首次康复治疗区域之间的差异显著更大（9.5%对13.4%，p < 0.001）。结果表明，与无NICU病史的个体相比，有NICU病史的个体的康复治疗次数和获得康复的机会更低。因此，需要国家支持以振兴康复程序并降低NICU组的医疗费用，进一步的研究应聚焦于振兴NICU康复的新方法。
