Bütüncül İzlem Modelinin Preterm Bebeklerin Nörolojik Ve Gelişimsel Sonuçları Üzerine Etkisi

Aim: The medical home also known as the patient-centered medical care, is a team based health care delivery model led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. The aim of the study is to compare the 2-year neurodevelopmental outcomes of very preterm infants who received health care in a medical home at a big maternity hospital in Turkey with the historical controls who delivered standard care. Material and Methods: Inborn infants who were ≤32 week’s gestation and discharged between September 2007 and December 2011 were enrolled to the study. Intervention group were prospectively followed within the concept of medical home (between September 2009 and December 2011) and the control group were followed with standard health care (between September 2007 and September 2009). At 18-24 months’ of corrected age, the neurological examinations and the developmental assessments using the Bayley Scales of Infant Development-II were performed. Results: The cerebral palsy rates in the intervention and control group were 10.6% (n=17) and 17.4% (n=27) respectively and the difference was not statistically significant (p=0.107). Whereas the rate of neurodevelopmental impairment in the intervention group was significantly lower than the control group (25% and 38.7%; p=0.011). Conclusion: Our data suggest that beginning a good follow-up process within the context of medical home, with efficient developmental support and guidance provided a reduction on neurodevelopmental impairment rate at 2 years of age.