Establishment of prospective payment systems have resulted in earlier hospital discharge and a shift in part of the care and cost burden from the hospital and third party payors to patients and families. The effects of this shift in burden on families' economic and functional status and patient outcomes is not clear. It is also not clear if this shift in burden is having a differential effect on families according to their income. The purpose of this study is to provide beginning information on family economic and functional status in families with very low birthweight infants (<- 1500 grams) and a comparison group of families of LBW infants (1500-2500 grams). Specifically, the study will attempt to answer the following questions: 1.What are the changes in family employment and financial status (changes in pattern or type of family employment; percentage of family income used to care for the infant; changes in family income) for the first 6 months post infant hospital discharge in families with varying levels of income? 2.What are the changes in family functional status and composition for the first 6 months post infant hospital discharge in families with varying levels of income? 3.What are the differences in infant outcomes (mortality, morbidity, growth and development, followup care and immunization status) for the first 6 months post infant hospital discharge in families with varying levels of income? The sample will consist of 98 families of VLBW infants and 98 families of LBW infants. Data will be analyzed using repeated measures analyses of covariance. Understanding the family care and cost burden is necessary to target interventions to achieve better functional outcomes for LBW and VLBW infants and their families.
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