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

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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Outpatient Healthcare Access and Utilization for Neonatal Abstinence Syndrome Children: A Systematic Review

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.418 ◽

2019 ◽

pp. 1-24

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

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

The Journal of Pediatrics ◽

10.1016/j.jpeds.2021.01.067 ◽

2021 ◽

Author(s):

Tammy E. Corr ◽

Xueyi Xing ◽

Guodong Liu

Keyword(s):

Healthcare Utilization ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

History Of

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Maternal opioid exposure, neonatal abstinence syndrome, and infant healthcare utilization: a retrospective cohort analysis

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2021.108704 ◽

2021 ◽

pp. 108704

Author(s):

Jean Y. Ko ◽

Jangho Yoon ◽

Van T. Tong ◽

Sarah C. Haight ◽

Roshni Patel ◽

...

Keyword(s):

Healthcare Utilization ◽

Retrospective Cohort ◽

Cohort Analysis ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

Retrospective Cohort Analysis

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Evaluation and analysis of the Modified Finnegan Scoring System for assessment of neonatal abstinence syndrome

Journal of Opioid Management ◽

10.5055/jom.2020.0567 ◽

2020 ◽

Vol 16 (3) ◽

pp. 189-196

Author(s):

Rafia Q. Baloch, MD ◽

Jamie M. Pinto, MD ◽

Patricia Greenberg, MS ◽

Yen-Hong Kuo, PhD ◽

Anita Siu, PharmD, BCPPS

Keyword(s):

Vital Sign ◽

Scoring System ◽

Neonatal Intensive Care ◽

Primary Outcome ◽

Assessment Tool ◽

Vital Signs ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

Scoring Tool ◽

Study Setting

Objective: The Finnegan Neonatal Abstinence Scoring System (FNASS) is the most commonly used scoring system for neonatal abstinence syndrome (NAS) both in its original and modified versions, despite challenges related to tool length and observer bias. The purpose of this study was to determine the most frequent symptoms of NAS that led to score elevation and prompted initiation of drug therapy on the Modified Finnegan (MF). We also sought to identify vital sign changes associated with score elevation.Design: We conducted a retrospective study of neonates diagnosed with NAS, based on ICD-9 codes and charge data for methadone administration.Setting: The study setting was in a Level III Neonatal Intensive Care Unit.Patients, Participants: Ninety patients with a total of 286 MF scores recorded from 2011 to 2015 met inclusion criteria.Main Outcome Measure(s): The primary outcome was overall occurrence for each specific component of the MF scoring tool during symptomatic periods. Secondary outcomes were vital sign changes.Results: Among the MF elements, there were 13 components that were scored more often than others in symptomatic infants. Respiratory rate (RR) was elevated in infants with NAS, but other vital signs did not differ from age-specific norms. Conclusions: Of the various signs of NAS used to score the MF, few are frequently observed. Our study reinforces literature that proposes a shortened MF assessment tool. Experimental research will be needed to determine the efficacy of a shortened MF tool for diagnosing NAS.

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