Abstract
Objective: The mortality rate of premature infants has decreased with the improvements in antenatal and neonatal care. Despite this decrease, the short- and long-term morbidity is increasing and requires specialized follow-up models for health and developmental risks. It is already known that premature infants at risks or with special needs have specifi c health, education, rehabilitation and social services requirements. The aim of the study was to determine the rate of unmet needs of premature infants in the health, education, rehabilitation and social services fi elds in a tertiary care situation with optimum conditions.
Material and Methods: Premature infants and children that presented to Ankara University School of Medicine’s Pediatrics and Developmental Pediatrics Outpatients Department were evaluated by specialists. During the assessment, the health, education-rehabilitation and social services needs and unmet needs were determined using the “Children with unmet needs Evaluation Form”.
Results: Forty-two premature infants aged 4-39 months were enrolled. The percentage of unmet needs was 55%, 36%, and 14% in the primary health care, education-rehabilitation and social services, and tertiary health care needs fi elds respectively.
Conclusion: There were unmet needs in the health care, education-rehabilitation and social services fi elds even when premature infants were followed by means of a medical home model and a tertiary care unit with optimum conditions. More studies are needed to determine the causes of continuing unmet needs in these fi elds and to develop preventive strategies to decrease the rate of unmet needs
Keywords: Medical home model, Unmet needs, Prematurity, Health-education and rehabilitation services
References
- Wen SW, Smith G, Yang Q, Walker M. Epidemiology of preterm birth and neonatal outcome. Semin Fetal Neonatal Med 2004;9:429-35.
- Ward RM, Beachy JC. Neonatal complications following preterm birth. BJOG 2003;110:8-16.
- Stephens BE, Vohr BR. Neurodevelopmental outcome of the premature infant. Pediatr Clin N Am 2009;56:631-46.
- Kelly MM. The medically complex premature infant in primary care. J Pediatr Health Care 2006;20:367-73.
- Robertson CM, Watt MJ, Dinu IA. Outcomes for the extremely premature infant: What is new? And where are we going? Pediatr Neurol 2009;40:189-96.
- Saigal S, Doyle LW. An overview of mortality and sequel of preterm birth from infancy to adulthood. Lancet 2008;371: 261-9.
- Aylward GP. Neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr 2005;26:427-40.
- Feldman HM, Buysse CA, Hubner LM, Huffman LC, Loe IM. Patient protection and affordable care act of 2010 and children and youth with special health care needs. J Dev Behav Pediatr 2015;36:207- 17.
- Kuo DZ, Cohen E, Agrawal R, Berry JG, Casey PH. A national profi le of caregiver challenges among more medically complex children with special health care needs. Arch Pediatr Adolesc Med 2011;165:1020-6.
- World Health Organization Action Plan 2014-2021. “Better Health for Persons with Disabilities, 2013. www.who.org.
- Hill KS, Freeman LC, Yucel RM, Kuhlthau KA. Unmet need among children with special health care needs in Massachusetts. Matern Child Health J 2008;12:650-61.
