Using Linked Data to Assess Patterns of Early Intervention (EI) Referral among Very Low Birth Weight Infants

Barfield, Wanda D.; Clements, Karen M.; Lee, Kimberly G.; Kotelchuck, Milton; Wilber, Nancy; Wise, Paul H.

doi:10.1007/s10995-007-0227-y

Cited by 86 publications

(71 citation statements)

References 33 publications

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“…First, consistent with results about EI referral in Massachusetts,13 enrollment in South Carolina was more likely among multiple-birth infants. Our findings also indicate that NMI V is independently correlated with enrollment; however, the heavier of these infants (750 to 999 g) were also more likely to be enrolled.…”

Section: Discussionsupporting

confidence: 79%

“…A study from Massachusetts that used linked data showed that 93% of infants born weighing <1200 g during 1998–2000 were referred to EI; however, the percentage enrolled was not reported 13. Another study showed that only 10% of children in the United States classified as having delays at 24 months received EI services; the latter study included all children born <1500g as well as other children who fit the criteria of delay 14…”

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confidence: 99%

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Factors Influencing the Enrollment of Eligible Extremely-Low-Birth-Weight Children in the Part C Early Intervention Program

Wang

Elliott

Rogowski

et al. 2009

Academic Pediatrics

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Objective To determine whether eligible extremely-low-birth-weight children (<1000 g) were enrolled in the federally enacted, state-coordinated Early Intervention (EI) program intended to help children with developmental delay or disability regardless of parental income, and the factors associated with enrollment. Methods Retrospective analysis of 884 EI-eligible ELBW children born in South Carolina with birth weight 401 to 999 g, gestation ≥24 weeks, and survival for the first 120 days of life. We created a linked data set with data from Early Intervention (1996–2001), Vital Records (1996–1998), death certificates, and Medicaid. Each child was followed from birth to 3 years old, the program eligibility period. Results A total of 54% of ELBW children were enrolled in EI at any time from birth to 36 months. Even among children ever enrolled in Medicaid (83% of all ELBW children), only 63% were enrolled in EI. Being born in a multiple gestational birth, having heavier birth weight (750 to 999 g), and having ever enrolled in Medicaid were positively associated with EI enrollment. Among Medicaid patients for whom perinatal data were available, additional risk adjustment showed that EI enrollment was more likely with birth in level 3 hospitals, birth weight 750 to 999 g, Neonatal Medical Index severity level V (most severe), and longer initial length of hospital stay. Conclusions Only about half of eligible ELBW children in South Carolina were enrolled—much lower than reported elsewhere. Efforts are needed to understand why eligible infants are not being enrolled and to develop strategies to remedy the situation.

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Section: Discussionsupporting

confidence: 79%

mentioning

confidence: 99%

Factors Influencing the Enrollment of Eligible Extremely-Low-Birth-Weight Children in the Part C Early Intervention Program

Wang

Elliott

Rogowski

et al. 2009

Academic Pediatrics

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“…17,25,26 Wang et al 20 reported higher EI enrollment among children with birth weights ,1000 g who were receiving public insurance. Results from our regression analyses also showed that EI referrals were positively associated with public insurance.…”

Section: Discussionmentioning

confidence: 99%

Missed Opportunities in the Referral of High-Risk Infants to Early Intervention

2012

PEDIATRICS

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“…Many of these risk factors are recognizable at the time of birth and recorded on birth or delivery hospitalization records. 14,15 Eligibility is determined by using an approved tool, the Battelle Developmental Inventory, Second Edition, or informed clinical opinion if the child does not meet the current definition of established condition or developmental delay when qualitative concerns can be documented. The most commonly used EI services include developmental specialists, occupational therapists, and speech and language pathologists.…”

Section: Data Sourcesmentioning

confidence: 99%

“…[4][5][6][7][8][9][10][11][12] Children with these adverse outcomes are at increased risk of poor developmental and behavioral outcomes and are specifically in need of Early Intervention (EI) programs. [13][14][15][16] Cognitive, behavioral, and social outcomes can be improved if developmental/behavioral interventions are initiated early in life. 15,17,18 These beneficial and longlasting services can be provided through EI programs to children with developmental delays or at risk for such delays at no cost.…”

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confidence: 99%

Assisted Reproductive Technology and Early Intervention Program Enrollment

et al. 2016

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We examined the prevalence of Early Intervention (EI) enrollment in Massachusetts comparing singleton children conceived via assisted reproductive technology (ART), children born to mothers with indicators of subfertility but no ART (Subfertile), and children born to mothers who had no indicators of subfertility and conceived naturally (Fertile). We assessed the natural direct effect (NDE), the natural indirect effect (NIE) through preterm birth, and the total effect of ART and subfertility on EI enrollment. METHODS:We examined maternal and infant characteristics among singleton ART (n = 6447), Subfertile (n = 5515), and Fertile (n = 306 343) groups and characteristics associated with EI enrollment includingpreterm birth using χ 2 statistics (α = 0.05). We estimated the NDE and NIE of the ART-EI enrollment relationship by fitting a model for enrollment, conditional on ART, preterm and the ART-preterm delivery interaction, and covariates. Similar analyses were conducted by using Subfertile as the exposure. RESULTS:The NDE indicated that the odds of EI enrollment were 27% higher among the ART group (odds ratio NDE = 1.27; 95% confidence interval (CI): 1.19 ̶ 1.36) and 20% higher among the Subfertilegroup (odds ratio NDE = 1.20; 95% CI: 1.12 ̶ 1.29) compared with the Fertile group, even if the rate of preterm birth is held constant. CONCLUSIONS:Singleton children conceived through ART and children of subfertile mothers both have elevated risks of EI enrollment. These findings have implications for clinical providers as they counsel women about child health outcomes associated with ART or subfertility.

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Using Linked Data to Assess Patterns of Early Intervention (EI) Referral among Very Low Birth Weight Infants

Abstract: In MA, most infants born <1,200 g are referred to EI, but disparities exist. Analysis of linked population-based health and developmental services can inform programs in order to reduce disparities and improve access for all high-risk infants.

Cited by 86 publications

References 33 publications

Factors Influencing the Enrollment of Eligible Extremely-Low-Birth-Weight Children in the Part C Early Intervention Program

Factors Influencing the Enrollment of Eligible Extremely-Low-Birth-Weight Children in the Part C Early Intervention Program

Missed Opportunities in the Referral of High-Risk Infants to Early Intervention

Assisted Reproductive Technology and Early Intervention Program Enrollment

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