Trends and challenges in United States neonatal intensive care units follow-up clinics

Objective:a mandate exists that all level iii neonatal intensive care units (nicus) provide a means to assess and follow their high-risk neonates after discharge. however, no standardized guidelines exist for the follow-up services provided. to determine trends of structure and care provided in nicu follow-up clinics in both the academic and private clinical setting.study design:we sent an internet survey to nicu follow-up clinic directors at both academically affiliated and private centers. this study received institutional review board exemption.result:we received 89 surveys from academic institutions and 94 from private level iii follow-up programs. these responses represent 55% of academic programs and 40% of private programs in the united states. similar to academic institutions, 18% of private nicu follow-up clinics provide primary care services to patients. in both settings, the hospital supports 60% of the funding required for clinic activities. forty-five percent of nicu graduates seen in both private and academic follow-up clinics have public aid as their primary insurance. eighty-five percent of nicus in both settings have guidelines outlining requirements for referrals to the follow-up clinic. academic programs find feeding difficulties the most difficult, whereas private programs find bronchopulmonary dysplasia and feeding difficulties equally as difficult.conclusion:the care and struggles of nicu follow-up clinics are similar in both the academic affiliated and private settings. similar referrals, clinical evaluation and medical care occur with varying struggles.