کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4139751 1272218 2014 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Impact of Newborn Follow-up Visit Timing on Subsequent ED Visits and Hospital Readmissions: An Instrumental Variable Analysis
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
پیش نمایش صفحه اول مقاله
Impact of Newborn Follow-up Visit Timing on Subsequent ED Visits and Hospital Readmissions: An Instrumental Variable Analysis
چکیده انگلیسی

ObjectiveTo determine whether newborn first outpatient visit (FOV) within 3 days of discharge is associated with reduced rates of emergency department (ED) visits and hospital readmissions.MethodsRetrospective cohort analysis was performed of all newborns who were born and had outpatient follow-up within a large academic medical center to determine whether they had ED visits or hospital readmission within 2 weeks after hospital discharge. Multivariable regression using an instrumental variable for timing of FOV was conducted to estimate the relationship between FOV within 3 days of discharge and ED visits and hospital readmissions within 2 weeks of discharge, adjusting for potential confounders. Stratified analyses assessed this relationship in subpopulations with medical or social risk factors.ResultsOf 3282 newborns, 178 (5%) had 1 or more ED visits or hospital readmissions within 2 weeks of hospital discharge. FOV within 3 days was not significantly associated with ED visits and readmissions in the instrumental variable analysis (IVA) (−0.035, P = .11) or the ordinary least squares analysis (OLS) (0.006, P = .52). The difference in coefficients between these analyses, however, suggests that IVA successfully adjusted for some unmeasured bias. In stratified analyses, only newborns born to African American mothers or discharged by family medicine providers demonstrated a significant relationship between FOV within 3 days and reduced odds of ED visits and readmissions.ConclusionsNo significant relationship between outpatient visit timing and ED visits and hospital readmissions was found. Further study is needed to assess the impact of early outpatient visits on other newborn outcomes.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Academic Pediatrics - Volume 14, Issue 1, January–February 2014, Pages 84–91
نویسندگان
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