Care of HIV-risk infants: nursing outreach by PNPs

Pediatric home care: reimbursement and cost benefit analysis

Home care has been described as the fastest growing component of personal health care spending, and pediatric home care as the fastest growing segment of the home care field. Because of the continued progress in pediatric medicine and advances in technology, a growing population of children with complex chronic and terminal conditions can be cared for at home. A growing subspecialty in pediatric health care is delivering services for infants and children with HIV infection or AIDS and those born to mothers addicted to drugs or alcohol. This article describes the reimbursement and cost-benefit issues surrounding pediatric home health care, with particular attention to the HIV/AIDS pediatric population.

Home intervention for in utero drug-exposed infants

Each year in the United States, around 5.5% (or 230,000) infants are born to mothers who used illicit drugs during pregnancy. The untoward effects of in utero drug exposure (IUDE) include significant decreases in birthweight and length and head circumference, prematurity, and developmental problems. Intensive early intervention, including home-based interventions, is recognized as an effective method to improve cognitive development and reduce health problems in these high risk infants and children. Examination of home visit records of 20 IUDE infants during their first year of life revealed frequent health and social problems. Infectious disease symptoms were the most frequent problem encountered in the home during the physical assessment of the infants. Of note was the mothers' lack of basic parenting information (understanding signs of illness, basic nutrition, and infant development) which was then provided by the nurse during each home visit. Of concern was the lack of drug treatment sought by these mothers. Findings support the view that home visiting should be incorporated into the discharge planning of any IUDE infant in order to maintain these infants in the health care system and monitor their safety.