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연구 정보

Research Project (승인과제목록)

KNN 연구 요약서

Title Implementation of health promotion program for very preterm infants after discharge: a pilot study for an alternative model
Author 송영화, 허주선, 신승한, 송준환, 진현승, 조희승, 임재우, 김이경, 이순민
작성자 이순민
Background Long-term follow-up after discharge is essential for preterm infants to enable early detection and intervention for developmental delays. In Korea, a national pilot program for the long-term follow-up of very preterm infants has been implemented using coordinator-based support. This program primarily utilizes shared coordinators to perform administrative tasks and provide caregiver counseling. However, in some hospitals, the shared-coordinator model is difficult to implement due to regional and institutional constraints.
Aim / Hypothesis This study aimed to assess the effectiveness of an individually assigned coordinator model by comparing follow-up outcomes before and after its implementation. The individually assigned coordinator model will improve follow-up completion rates at 18–24 months compared with the pre-implementation period.
Inclusion Criteria Pre-implementation: 2018-2019년도에 출생하여 KNN에 등록되었으며, 18-24개월 장기 추적관찰이 이루어진 경우 Post- implementation: 2021-2022년도에 출생하여 KNN에 등록되었으며, 18-24개월 장기 추적관찰이 이루어진 경우
Exclusion Criteria 신생아 시기 혹은 퇴원 전 사망한 경우 KNN 대상이 아닌 병원으로 옮겨지거나 해외로 가서 경과관찰이 이루어지지 않은 경우
Study Design Statistical methods This multicenter retrospective quasi-experimental pre–post study was conducted using data from the Korean Neonatal Network (KNN). Continuous variables were expressed as mean ± standard deviation and compared using Student’s t-test. Categorical variables were presented as frequencies and percentages and compared using the chi-square test. A p-value < 0.05 was considered statistically significant.
Primary Outcomes The primary outcome was the follow-up completion rate at 18–24 months’ corrected age. Follow-up completion was defined as successful contact through either an in-person clinic visit or a structured telephone survey within the designated follow-up window.
Secondary Outcomes and Definitions 1) In-person visit rate at 18–24 months’ corrected age, defined as attendance at a clinic visit within the designated follow-up window. 2) Neurodevelopmental assessment outcomes at 18–24 months’ corrected age, including cognitive, language, and motor outcomes based on the Bayley Scales of Infant and Toddler Development. 3) Completion rates of developmental assessments at 18–24 months’ corrected age. 4) Social service referral rate during the follow-up period. 5) Utilization of coordinator services, measured by the number of contacts per patient. 6) Caregiver and healthcare provider satisfaction scores.
Protocols This study compared a pre-implementation period and a post-implementation period of a health promotion program for very preterm infants. In the post-implementation period, each participating hospital utilized an individually assigned coordinator responsible for follow-up scheduling, caregiver communication, and linkage to developmental and social services. Coordinators scheduled follow-up visits prior to discharge, provided reminders during designated follow-up windows, and facilitated referrals to social services when developmental concerns were identified. A standardized follow-up schedule was applied at corrected ages of 4, 8, 18, and 24 months, and at 3 years of chronological age. In the pre-implementation period, follow-up was conducted without a structured coordinator-based system and without a standardized early follow-up schedule.
Funding “본 연구는 이건희 소아암‧희귀질환 극복사업 재원으로 서울대학교병원 소아암‧희귀질환지원사업단 선정 및 지원에 의하여 이루어진 것임 (과제번호 : 26C-077-0100).”

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