Patterns of Health Care Utilization by Infants with Neonatal Abstinence Syndrome

Objective. The opioid crisis in the United States has led to an increase in infants diagnosed with Neonatal Abstinence Syndrome (NAS). There is a lack of information regarding the use of pediatric follow-up care by infants diagnosed with NAS. The purpose of this project was to analyze healthcare utilization for infants diagnosed with NAS during the first year of life in comparison to a cohort of well newborns. Methods. A retrospective medical record review was completed on infants with a diagnosis of NAS and well newborns that were born in four Intermountain Healthcare facilities. A comparison was made to assess whether the infants with NAS required health care services at a similar, increased, or decreased frequency than well newborns. Results. During the calendar year 2016, 15,619 infants were born in the four Intermountain Healthcare facilities. Sixty-four infants with a diagnosis of NAS were identified. The NAS and well newborn infants required emergent and urgent care services at a similar frequency. The infants with NAS were hospitalized at an increased frequency in comparison to the well newborns (15.6% vs. 4.7%). Fifty-four (84%) well newborns were fully immunized, whereas 50 (78%) NAS diagnosed infants were fully immunized. The lack of a universal electronic health record complicated access to pediatric office visits. Only 34% of the pediatricians used the Intermountain Healthcare electronic health record, thereby limiting access to information about follow-up care. Conclusion. Our findings demonstrate that infants diagnosed with NAS were four times as likely to be readmitted to the hospital during the first year of life. Otherwise the use of the health care system is similar to that of well newborns. Immunization rates for both populations are above that of the US rate.