CONTINUING EVOLUTION OF REGIONALIZED PERINATAL-CARE - COMMUNITY-HOSPITAL NEONATAL CONVALESCENT CARE

We describe the convalescent care of 169 back-transported (to communit y hospitals) and 285 eligible but not back-transported very low birth weight (VLBW) infants. Eligible infants who were not back transported to a level I or II community hospital were transferred to a level II n ursery within the Medical University of South Carolina (MUSC) for conv alescent care. Study infants were admitted to the neonatal intensive c are unit (NICU) at MUSC from July 1985 through June 1989. They were ad mitted after maternal transport to MUSC for imminent delivery (N = 159 ), out-born community delivery (N = 55), or in-born MUSC delivery (N = 240). The mean +/- SD birth weight and gestational age and the NICU a dmission diagnoses for the back-transported and non-back-transported n eonates were similar. The mean +/- SD weight of neonates at the time t hey were back transported was significantly greater than the weight of neonates at the time of intrahospital transfer. In contrast, the disc harge weight to home and total days hospitalized were significantly le ss in the back-transported infants. Five back-transported neonates (3% ) and 12 non-back-transported neonates (4%) were readmitted to the NIC U. The back-transported infants used more than 3,800 bed days at commu nity hospitals that would otherwise have been spent in the regional ce nter, thus facilitating increased parental and primary physician invol vement in their care.