Josiah Brown Poster Abstract

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Chanae R. Hardamon
Gerardo Moreno, MD, MSHS
Patrick T. Dowling, MD, MPH
BARRIERS TO POST-NICU HIGH-RISK INFANT OUTPATIENT FOLLOW-UP CARE
Family Medicine Summer Fellowship

BACKGROUND: Infants recently discharged from the Neonatal Intensive Care Unit (NICU) who are at high risk for neurodevelopmental impairment are typically referred for early intervention services. Along with limited resources to care for this vulnerable population, socioeconomic factors can impede families from receiving outpatient follow-up care to prevent and address developmental deficiencies. Moreover, low socioeconomic status (SES) has been shown to be associated with poor health outcomes, including neural development. As such, accurately identifying barriers and facilitators that affect post-NICU follow-up care is of great importance, especially for post-NICU infants with low SES. OBJECTIVE: The goal of this exploratory study was to identify and understand barriers that interfere with post-NICU outpatient follow-up care for infants at high risk of neurodevelopmental impairment. METHODS: We conducted a qualitative study consisting of one-on-one telephone or in-person interviews with key stakeholders from different disciplines involved with high-risk infant follow-up (HRIF) clinics and postnatal care in Los Angeles and San Diego counties to identify a range of major recurring themes that were perceived to interfere with the performance of and receipt of outpatient follow-up care. An interview script was used to guide the interviews. RESULTS: Among all conducted interviews, preliminary results show a multitude of factors – both patient and provider-centered – that can hinder families from receiving post-NICU HRIF care. Some preliminary themes include transportation barriers, competing social demands for families, lack of multidisciplinary healthcare providers and teams, and language barriers. Additional interviews are being scheduled, and final results will be presented in the future. CONCLUSION: There are a considerable number of barriers to post-NICU HRIF care. Because post-NICU infants are a highly vulnerable population, there is a critical need to address medical and non-medical barriers that may impede outpatient follow-up as a way to address neurodevelopmental delay and impairments. A team-based approach is needed that extends beyond a clinical setting to a patient’s own home and community, and encompasses policy change to account for social and medical barriers to post-NICU follow-up care.

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