Even less expensive home visiting programs lead to dramatic savings in emergency care for infants, according to a study.
Infants in the study group had 50% fewer emergency care episodes than other babies in the first year of life, reported researchers with Duke University in Durham, N.C.
For a relatively small investment, the reward is significant, Kenneth A. Dodge, PhD, the studys lead author, a Duke professor of public policy and director of the universitys Center for Child and Family Policy, said in a news release.
The study, which was published Nov. 1 in a special issue of Pediatrics devoted to home visiting, looks at Durham Connects, a program that provides home visits for newborns and their parents in Durham, N.C. Dodge and Benjamin Goodman, PhD, a Duke research scientist, found that participating families visited the ED less often than control-group families and had fewer overnight hospital stays.
The results held true a year after birth, well after the nurses contact with the family had ended.
The findings have significant cost implications because the price of ED visits and overnight stays often ranges into the thousands of dollars, the researchers noted. In contrast, the Durham Connects program costs an average of $700 per family.
Home visiting encompasses a wide array of approaches. Many programs are intensive, multiyear efforts targeted to poor families that can cost $4,000 per family or more. Durham Connects costs less because it is relatively brief and makes extensive use of referrals.
The program was developed by Duke University in partnership with the Durham County Health Department and the Center for Child and Family Health. A nurse visits new parents soon after their newborn comes home from the hospital, checks the health of the mother and baby and offers the parents tips on topics such as breast-feeding and child care. Nurses also screen for potential problems such as maternal depression.
But the nurses are not primarily caseworkers. Instead, they serve to link families who need help with appropriate community services over a series of one to three home visits.
To gauge the programs effects, the Duke research team designed a study that divided into two groups all of the 4,777 babies born in Durham County between July 1, 2009, and Dec. 31, 2010. Those born on even dates were offered the program, while those born on odd dates were not. The authors analyzed medical records for a random subsample of those families.
In addition to an overall reduction in emergency care episodes, the authors found a decrease in use of emergency care for all subgroups studied. While some groups benefited more than others, the pattern held true for both single- and two-parent families, for families receiving Medicaid and for privately insured families.
High-risk families were not the only ones who benefited, Goodman said in the news release. All families benefited. It was great to have this kind of finding almost a full year after the program was implemented.
Study abstract: http://pediatrics.aappublications.org/content/132/Supplement_2/S140.abstract