In:
Hospital Pediatrics, American Academy of Pediatrics (AAP), Vol. 13, No. 10 ( 2023-10-01), p. 945-953
Abstract:
Substance-exposed newborns (SENs) are at risk for developmental delay(s). Early intervention (EI) access, key to addressing these risks, is inequitable. Objectives were to: 1. determine prevalence of EI referral in the Colorado Hospitals Substance-Exposed Newborn Quality Improvement Collaborative; and 2. evaluate predictors of referral. METHODS Within participating Colorado Hospitals Substance-Exposed Newborn hospitals, maternal–infant dyads with exposure to medications for opioid use disorder (MOUD), illicit/prescription opioids, and/or nonopioid substances were included on the basis of electronic medical record documentation. χ2, Fisher’s exact, and analysis of variance tests evaluated differences in maternal/infant characteristics by referral. Multivariable Poisson regression models assessed the independent association of characteristics with referral. RESULTS Among 1222 dyads, 504 (41%) SENs received EI referral. Infants born to mothers with non-MOUD (adjusted risk ratio [aRR] 2.15, 95% confidence interval [CI] 1.67–2.76) and polysubstance (aRR 1.58, 95% CI 1.26–1.97) exposure were less likely to receive referral compared with infants born to mothers with MOUD exposure. Those with private (aRR 1.26, 95% CI 1.03–1.55) or self-pay/no insurance (aRR 12.32, 95% CI 10.87–13.96) were less likely to receive referral compared with infants with public insurance. CONCLUSIONS Less than half of identified SENs received EI referral, with variation by substance exposure and maternal insurance status. Systems to ensure equitable access to services are crucial.
Type of Medium:
Online Resource
ISSN:
2154-1663
,
2154-1671
DOI:
10.1542/hpeds.2023-007161
Language:
English
Publisher:
American Academy of Pediatrics (AAP)
Publication Date:
2023
Bookmarklink