The effect of newborn early discharge follow-up program on pediatric urgent care utilization.

Introduction: The effects of an early discharge follow-up program on the subsequent use of urgent care services by newborn infants at Kaiser Permanente in Fontana, Calif, was evaluated to test the hypothesis that participation in the follow-up program would result in a significant decrease in utilization of urgent care services.

Method: Through records review, the effects of a new early discharge follow-up program on the rate of use of urgent care services was examined. Use of urgent care services by 324 early discharged newborn infants who were born before the new program was initiated was measured and compared with the use of urgent care services by 315 early discharged newborn infants whose parents had attended the program.

Results: Of the infants born before the new program was initiated, 58% used urgent care services before the 2- to 3-week newborn checkup. The group that participated in the new program used urgent care at the lower rate of 28%; thus the hypothesis was confirmed.

Discussion: Follow-up programs in which qualified nurse practitioners provide care for both the mother and newborn infant are demonstrated to decrease the utilization of urgent care services and better meet the needs of the infant and mother. Innovative and collaborative nurse practitioner-managed programs such as Great Starts are needed to ensure quality care in today's rapidly changing health care environment.