Online Survey Examines Current Standard of Care and How It has Evolved
GAITHERSBURG, Md., Feb. 19 /PRNewswire-FirstCall/ -- A recent survey of
202 neonatologists and pediatricians, which examined current attitudes and
practices when caring for the specialized health needs of preterm infants,
revealed that most respondents (70 percent) feel the United States' healthcare
system does not place enough emphasis on or dedicate enough resources to
preventive healthcare for preemies. The survey was sponsored by MedImmune,
The incidence of preterm birth, when infants are born at less than 36
weeks gestation, has increased steadily in the United States since the mid-
1990s. Because these babies lack the usual complement of antibodies, which are
supplied by the mother to babies in late gestation, preterm babies are at high
risk of getting a host of infectious diseases, including respiratory syncytial
virus (RSV), the leading cause of infant respiratory hospitalization in the
United States. That risk can be even greater among infants that have an array
of complex health problems including immune deficiencies, chronic lung
disease, congenital heart disease and neurological disorders.
"This survey reminds us that, while progress in preemie healthcare has
been made, more still needs to be done to ensure that every preemie,
regardless of his or her circumstances, receives the care he or she deserves,"
said Richard J. Martin, M.D., division chief of neonatology, Rainbow Babies
and Children's Hospital, Cleveland, Ohio.
Additional key survey findings shed light on reasons why premature infants
may not receive the specialized care they require:
Preemie care practices differ among doctors with varying levels of
-- More than half (53 percent) of pediatricians with 10 years of
experience or less relied on parents to find out if a patient was born
prematurely, compared with just 14 percent of pediatricians with 21
plus years of experience. The more experienced pediatricians favored
the hospital discharge summary (43 percent) or communication with the
child's neonatologist for this information (36 percent).
-- Twenty-one percent of neonatologists with more than 10 years of
experience said providing parents with a copy of their child's
discharge plan is the most important step when discharging a preemie
from the hospital. Only three percent of neonatologists with fewer
years of experience named this as the most important step.
-- Most pediatricians (56 percent) with 10 years of experience or less
said they stop working with a preemie's neonatologist immediately
following discharge, whereas most pediatricians (54 percent) with 21
plus years of experience keep working with the neonatologist until
their patient is at least three months old.
Late-preterm infants (defined as 34-to-35 weeks gestational age for the
purpose of the survey) may not be on their doctors' "radars" because of
misconceptions about the risks these babies face.
-- Fifty-eight percent of 34-to-35 week infants are perceived, by their
surveyed doctors, as healthy (not at high-risk), even though they are
premature and at high risk for RSV disease.
Doctors agree that there are a number of reimbursement and managed-care
barriers to effective preemie care.
-- Most physicians (70 percent) feel that the U.S. healthcare system does
not dedicate enough emphasis and resources to preventive healthcare for
-- Eighty-four percent of these physicians say they are willing to
personally advocate for more preventive health services for
-- Most pediatricians (69 percent) say their office staff spends more time
on reimbursement for premature infants than for full-term babies.
Seventy-seven percent say they spend more time on reimbursement for
premature babies at high risk for serious RSV than for preemies who are
not at high risk for serious RSV.
About the Survey
HCD Research, an independent research company, surveyed a random sample of
202 neonatologists and pediatricians from September 5 to 25, 2007. To qualify,
respondents had to have spent at least 50 percent of their time in a clinical
setting, with neonatologists treating at least three preemies per month and
pediatricians treating at least three preemies in the past four months.
Respondents with an existing financial relationship with an advertising
agency, the U.S. Food and Drug Administration or a market research firm were
excluded. No incentive was offered in exchange for respondents' participation.
Ninety-seven neonatologists participated in the survey. Thirty-two
neonatologists had 10 years of experience or less, 37 neonatologists had
between 11 and 20 years of experience, and 28 neonatologists had at least 21
years of experience. A total of 105 pediatricians participated in the survey.
Twelve were pediatric pulmonologists and 15 were pediatric cardiologists.
Thirty-two pediatricians had 10 years of experience or less, 45 pediatricians
had between 11 and 20 years of experience, and 28 pediatricians had at least
21 years of experience.
Each year, up to 125,000 infants in the United States are hospitalized
with severe RSV infections, the leading cause of infant hospitalization in the
U.S. Approximately one-half of all infants are infected with RSV during the
first year of life, and nearly all children have been infected at least once
by the time they reach their second birthday. In the United States, RSV causes
up to 1.7 million physician office visits; 400,000 emergency room visits and
more than 230,000 hospital outpatient emergency room visits per year. RSV is
the most common respiratory infection in infancy or childhood. Children born
prematurely as well as those with chronic lung disease or congenital heart
disease are at highest risk for severe disease and hospitalization due to RSV.
In addition, some 25-40% of infants in the first year of life infected with
RSV develop lower respiratory tract infections (such as bronchiolitis or
pneumonia) which can additionally compromise the hearts and lungs of these
high-risk infants (1). The virus may also cause severe illness in populations
such as the elderly, those with underlying respiratory or cardiac disease, and
those with compromised immune systems (e.g., bone marrow transplant patients).
MedImmune strives to provide better medicines to patients, new medical
options for physicians and rewarding careers to employees. Dedicated to
advancing science and medicine to help people live better lives, the company
is focused on cardiovascular/gastrointestinal disease, neuroscience, oncology,
infection, respiratory disease and inflammation. With approximately 3,000
employees worldwide and headquarters in Maryland, MedImmune is wholly owned by
AstraZeneca plc (LSE: AZN.L, NYSE: AZN). For more information, visit
MedImmune's website at http://www.medimmune.com.
(1) http://www.cdc.gov/ncidod/dvrd/revb/respiratory/rsvfeat.htm. Viewed
February 15, 2008.
CONTACT: Tor Constantino of MedImmune, +1-301-398-5801