Reducing postneonatal mortality in West Virginia : a statewide intervention program targeting risk identified at and after birth.
Excessives postneonatal mortality in West Virginia has been associated with inadequate health care.
This paper describes two interventions aimed at those infants at greatest risk of dying.
Two systems of risk-related intervention were simultaneously introduced and funded statewide from 1985 through 1987.
Risk status was determined by a multifactorial score at birth or clinical risk factors later.
At-risk infants were linked with physicians who provided specified care plants.
All infants were followed for 1 year for mortality.
Of 4570 infants with a high Sheffield Birth Score, 45%, together with 1003 infants with clinical risk factors, received specified care plans.
High-risk infants constituted 7.6% of total resident births.
Odds ratios for overall postneonatal mortality and sudden infant death syndrome in high-birth-score infants compared with low-birth-score infants were 6.2 (95% confidence interval [CI]=4.2,9.3) abd 11.2 (95% CI=5.4,23.2), respectively.
During the program there was a 21.4% reduction in the trend of yearly standardized mortality ratios, which differed markedly from the trend in surrounding states.
The data suggest that 33 lives were saved at a cost $36 363 per infant.
Ensuring affordable, available, accessible, and acceptable care for a small group of at-risk infants was associated with a dramatic drop in overall postneonatal mortality in West Virginia.
Mots-clés Pascal : Mortalité, Postnatal, Nouveau né, Virginie Occidentale, Programme sanitaire, Dépistage, Risque élevé, Planification, Soin, Prévention, Evaluation, Homme, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Mortality, Postnatal, Newborn, West Virginia, Sanitary program, Medical screening, High risk, Planning, Care, Prevention, Evaluation, Human, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0318489
Code Inist : 002B30A01A2. Création : 01/03/1996.