Using linked data to assess patterns of Early Intervention (EI) referral among very low birth weight infants.
OBJECTIVES: Access to Early Intervention (EI) services may improve cognitive and behavioral outcomes in very low birth weight infants, but few states have population-based data to evaluate EI outreach efforts. We analyzed Massachusetts (MA) infants born weighing <1,200 g to identify maternal and bir...
| Publicado en: | Maternal & Child Health Journal Vol. 12; no. 1; pp. 24 - 34 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jan2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105840164&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105840164 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10927875 N9J jtl: Maternal & Child Health Journal issn: 10927875 maglogo: N pubinfo: dt: Jan2008 vid: 12 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 105840164 105840164 2009753736 10.1007/s10995-007-0227-y NLM17562149 105840164 ppf: 24 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Using linked data to assess patterns of Early Intervention (EI) referral among very low birth weight infants. aug: au: Barfield WD Clements KM Lee KG Kotelchuck M Wilber N Wise PH affil: Massachusetts Department of Public Health, Center for Community Health, 250 Washington Street, 5th floor, Boston, MA 02138 USA. sug: subj: Behavior Therapy Evaluation Early Intervention Massachusetts Infant, Low Birth Weight Apgar Score Birth Weight Black Persons Chi Square Test Child, Preschool Cognitive Therapy Confidence Intervals Cox Proportional Hazards Model Data Analysis Software Descriptive Statistics Epidemiological Research Female Funding Source Gestational Age Hispanic Americans Infant Insurance, Health International Classification of Diseases Kaplan-Meier Estimator Massachusetts Mothers Multivariate Analysis Outcome Assessment Pregnancy Pregnancy Outcomes Prenatal Care Utilization Public Health Race Factors Referral and Consultation Socioeconomic Factors White Persons Human Child, Preschool: 2-5 years Infant: 1-23 months Female ab: OBJECTIVES: Access to Early Intervention (EI) services may improve cognitive and behavioral outcomes in very low birth weight infants, but few states have population-based data to evaluate EI outreach efforts. We analyzed Massachusetts (MA) infants born weighing <1,200 g to identify maternal and birth characteristics that predicted EI referral and timing of referral. METHODS: MA birth and hospital discharge records (Jan. 1998-Sept. 2000) were linked to EI referral records (Jan. 1998-Sept. 2003) via probabilistic and deterministic methods (88% linkage). Timing of EI referral among infants weighing <1,200 g was examined by infant and maternal characteristics using categorical (0-12 months, 12-36 months, or no referral) time comparisons in the crude analysis. Survival functions calculating median time to referral, and adjusted hazard ratios (HR) with 95% confidence intervals (CI) were calculated for continuous time comparisons of EI referral from birth to 36 months. RESULTS: Of 1,233 infants weighing <1,200 g, 93.2% were referred to EI. After risk adjustment, referral was more likely among multiple-birth infants (HR = 1.17, 95%CI 1.06-1.30) and less likely among infants <28 weeks (HR = 0.70; 95%CI 0.64-0.77) or with low Apgar scores (<5 at 5 min; HR = 0.75; 95%CI 0.62-0.92). EI referrals were lower for infants of black non-Hispanic mothers, and mothers without private insurance (HR = 0.85; 95%CI 0.74-0.98 and HR = 0.77; 95%CI 0.68-0.86, respectively). CONCLUSIONS: In MA, most infants born <1,200 g are referred to EI, but disparities exist. Analysis of linked population-based health and developmental services can inform programs in order to reduce disparities and improve access for all high-risk infants. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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