Nurse navigator support for families of high-risk newborns did not raise costs to the public health system and may help families access the care their infants need after leaving the neonatal intensive care unitNeonatal intensive care unit A specialized hospital unit for newborns who need close monitoring and treatments such as platelet transfusions. (NICUNeonatal intensive care unit A specialized hospital unit for newborns who need close monitoring and treatments such as platelet transfusions.), according to a study recently published in the journal Children.
Infants born early or with complex medical needs often spend their first weeks in the NICU and continue to need care after going home. Because fetal-neonatal alloimmune thrombocytopenia (FNAITFetal and neonatal alloimmune thrombocytopenia A rare condition in which a mother’s immune system attacks fetal platelets, leading to dangerously low platelet levels before and/or after birth.) can lead to premature birth or bleeding complications that require NICU care, families navigating an FNAIT-affected pregnancy may face those challenges after discharge.
An integrated care approach that includes a nurse navigator may help families move from the NICU to home by offering coaching, psychosocial support, guidance and education, and by making it easier to reach the right services during the first year after discharge.
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Researchers analyzed one such approach, the Coached, Coordinated, Enhanced Neonatal Transition (CCENT) program, which paired each family with a nurse navigator who provided emotional support, coordinated care with the infant’s medical team and helped educate families. The trial enrolled families across seven NICUs in Ontario, Quebec and British Columbia, randomly assigning 97 infants to the program and 105 to standard care.
Annual health care costs per child to the public system were similar between the two groups, about $4,135 Canadian dollars (CAD) for the program group and $4,578 CAD for the standard care group, a difference that was not statistically significant. Delivering the program added roughly $669 CAD per family. Families paid an average of a little over $700 CAD per year out of pocket in both groups, largely for private mental health care and home equipment.
Most of the out-of-pocket expenses went toward private mental health care and equipment for caring for the infant at home. Many parents paid for their own mental health support, with 13% to 23% of primary caregivers and 1% to 7% of their partners seeking paid mental health services to help them cope with their child’s condition.
“These programs must consider the mental health needs of parents,” the authors stated.
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