Overview
Infants born preterm and with a Low Birth Weight (LBW) have a greater risk for long-term health issues than infants who are born full-term. To reduce that risk and foster better health outcomes, the Following Baby Back Home (FBBH) program offers families of these infants additional support after their discharge from the Neonatal Intensive Care Unit (NICU) through health-centered home visiting services.
Home Visiting for NICU Graduates: Impacts of Following Baby Back Home
The Following Baby Back Home (FBBH) home visiting program supports families of high-risk low birth weight preterm infants after discharge from a hospital NICU. Research has compared the health care use, immunization, and infant mortality rate of low-birth-weight preterm infants enrolled in FBBH with statistically matched infants not in the program.
Lorraine M. McKelvey, Kanna N. Lewis, Jared Beavers, Patrick H. Casey, Carmen Irby, Anthony Goudie; Home Visiting for NICU Graduates: Impacts of Following Baby Back Home. Pediatrics July 2021; 148 (1): e2020029397. 10.1542/peds.2020-029397
Abstract: This study compares the health care use, immunization, and infant mortality rate of low-birth-weight preterm infants enrolled in FBBH with similar infants not in the program. From January 2013 to December 2017, 498 children enrolled in FBBH were identified in Arkansas vital statistics records and the Arkansas All-Payer Claims Database. Infants in FBBH were matched with children in a control group on the basis of demographics and medical conditions of the infant. Generalized linear mixed models with double propensity-score adjustment were used to estimate program effects. In the first year after discharge and compared with a propensity-score matched cohort of control infants, those enrolled in FBBH were significantly more likely to have higher numbers of medical appointments and more compliant immunization history. The odds of dying in the first year of life for control infants was 4.4 times (95% confidence interval: 1.2–20.7) higher than those managed in the program. A goal of the FBBH home visiting program is to work with parents to educate and support them as they care for their medically fragile infants. We conclude that education and support was instrumental in the infant health care use and outcome differences we observed during the first year of life.
Lewis, Kanna N., et al. “Cost-benefit analysis of home visiting to reduce infant mortality among preterm infants.” Journal of Pediatric Nursing 71 (2023): e112-e119.
Abstract:
Enrollment in the FBBH program has been documented to reduce the likelihood of infant death. In this study, we conducted a cost-benefit analysis of the FBBH program. Infants enrolled in the FBBH program (N = 416) were identified through administrative records. Infants in the FBBH program were propensity score matched with comparison infants to estimate the difference in healthcare costs in the first year of life. Infants enrolled in the FBBH program incurred similar medical care costs compared to a comparison group. Avoided deaths, program costs, healthcare costs resulted in net economic benefits of the FBBH program to avoid infant death estimate at $83,020, cost per life saved at $3080, and benefit-to-cost ratio at 27.95. The FBBH program’s net economic benefits from avoided deaths suggest a substantial return on investment of resources, yielding benefits in excess of program and healthcare costs. It is economically beneficial to provide home visiting services to families of low-birthweight babies by a team comprised of a registered nurse and social worker.
Link: https://www-sciencedirect-com.libproxy.uams.edu/science/article/pii/S0882596323001112
Report Description
Efforts to evaluate the effectiveness of the FBBH program are ongoing. Analyses continue to examine the experiences and outcomes of participating children and families. Using administrative and other data sources, these studies compare program participants with matched nonparticipants to assess the program’s potential impacts across multiple domains. Findings from this body of work are reported across a series of reports that collectively contribute to a growing evidence base regarding the effectiveness of FBBH.
