Longitudinal Healthcare Utilization of Medicaid-Insured Children with a History of Neonatal Abstinence Syndrome

Abstract Objective: The objective of this study was to systematically assess the literature regarding postnatal healthcare utilization and barriers/facilitators of healthcare in neonatal abstinence syndrome (NAS) children. Methods: A systematic search was performed in PubMed, Cochrane Database of Systematic Reviews, PsychINFO, CINAHL, and Web of Science to identify peer-reviewed research. Eligible studies were peer-reviewed articles reporting on broad aspects of primary and specialty healthcare utilization and access in NAS children. Three investigators independently reviewed all articles and extracted data. Study bias was assessed using the Newcastle-Ottawa Assessment Scale and the National Institute of Health Study Quality Assessment Tool. Results: This review identified 14 articles that met criteria. NAS children have poorer outpatient appointment adherence and have a higher rate of being lost to follow-up. These children have overall poorer health indicated by a significantly higher risk of ER visits, hospital readmission, and early childhood mortality compared with non-NAS infants. Intensive multidisciplinary support provided through outpatient weaning programs facilitate healthcare utilization and could serve as a model that could be applied to other healthcare fields to improve the health among this population. Conclusions: This review investigated the difficulties in accessing outpatient care as well as the utilization of such care for neonatal abstinence syndrome infants. NAS infants tend to have decreased access to, and utilization of outpatient healthcare following hospital birth discharge. Outpatient weaning programs have proven to be effective; however, these programs require intensive resources and care coordination that has yet to be implemented into other healthcare areas for NAS children.

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Outpatient healthcare access and utilization for neonatal abstinence syndrome children: A systematic review

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.407 ◽

2019 ◽

Vol 4 (5) ◽

pp. 389-397

Author(s):

Adam Van Horn ◽

Whitney Powell ◽

Ashley Wicker ◽

Anthony D. Mahairas ◽

Liza M. Creel ◽

...

Keyword(s):

Healthcare Utilization ◽

Assessment Tool ◽

Healthcare Access ◽

Childhood Mortality ◽

Neonatal Abstinence Syndrome ◽

Health Study ◽

Abstinence Syndrome ◽

Appointment Adherence ◽

Cochrane Database ◽

Lost To Follow Up

AbstractObjective:The objective of this study was to systematically assess the literature regarding postnatal healthcare utilization and barriers/facilitators of healthcare in neonatal abstinence syndrome (NAS) children.Methods:A systematic search was performed in PubMed, Cochrane Database of Systematic Reviews, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science to identify peer-reviewed research. Eligible studies were peer-reviewed articles reporting on broad aspects of primary and specialty healthcare utilization and access in NAS children. Three investigators independently reviewed all articles and extracted data. Study bias was assessed using the Newcastle–Ottawa Assessment Scale and the National Institute of Health Study Quality Assessment Tool.Results:This review identified 14 articles that met criteria. NAS children have poorer outpatient appointment adherence and have a higher rate of being lost to follow-up. These children have overall poorer health indicated by a significantly higher risk of ER visits, hospital readmission, and early childhood mortality compared with non-NAS infants. Intensive multidisciplinary support provided through outpatient weaning programs facilitates healthcare utilization and could serve as a model that could be applied to other healthcare fields to improve the health among this population.Conclusions:This review investigated the difficulties in accessing outpatient care as well as the utilization of such care for NAS infants. NAS infants tend to have decreased access to and utilization of outpatient healthcare following hospital birth discharge. Outpatient weaning programs have proven to be effective; however, these programs require intensive resources and care coordination that has yet to be implemented into other healthcare areas for NAS children.

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Active Ear Acupuncture Points in Neonates with Neonatal Abstinence Syndrome (NAS)

The American Journal of Chinese Medicine ◽

10.1142/s0192415x11008622 ◽

2011 ◽

Vol 39 (01) ◽

pp. 29-37 ◽

Cited By ~ 11

Author(s):

Wolfgang Raith ◽

Jörg Kutschera ◽

Wilhelm Müller ◽

Berndt Urlesberger

Keyword(s):

Optical Signal ◽

Mean Value ◽

Ear Acupuncture ◽

University Hospital ◽

Neonatal Abstinence Syndrome ◽

Acupuncture Points ◽

Abstinence Syndrome ◽

History Of ◽

One Year ◽

The University

The aim of the study was to determine the presence of acupuncture ear points in neonates with Neonatal Abstinence Syndrome (NAS). NAS occurs in the first days of life in neonates whose mothers have a history of drug abuse, and may also occur in neonates whose mothers are currently following substitution therapy. The patients are neonates with NAS admitted over one year to the Division of Neonatology at the University Hospital Graz. The examination took place on the third day after delivery (mean value 70.3 hours) and was performed by a neuronal pen (PS 3 © Silberbauer, Vienna, Austria). An integrated sound and optical signal detected the active ear points that were then placed on an ear map. We investigated six neonates (four male, two female). All investigated neonates showed the presence of active ear acupuncture points. The psychovegetative rim was the most common organic area of the children, following by a few organic points. This corresponds with the results found in healthy neonates. In all neonates with NAS, we found the presence of psychic ear points. The identified psychic ear points are the frustration-point, R-point and the psychotropic area nasal from the incisura intertragica. In all neonates with NAS, active organic and psychic ear points were detectable in both ears. In the future, it could be possible to use active ear points for diagnostic and therapeutic purposes.

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