Parental Satisfaction and Anxiety Following Newborn Hearing Screening Referrals in Utah Linda D....

28
EIR I EIR I Parental Satisfaction and Anxiety Following Newborn Hearing Screening Referrals in Utah Linda D. Goetze, Catherine C. Groseclose, Scott Grosse, Karl R. White, and Kay W. Hansen Early Intervention Research Institute Utah State University Logan, UT 84322-6580 www.eiri.usu.edu [email protected] Presented at: National Early Hearing Detection and Intervention Conference Washington, DC February 19, 2004

Transcript of Parental Satisfaction and Anxiety Following Newborn Hearing Screening Referrals in Utah Linda D....

EIRIEIRI

Parental Satisfaction and Anxiety Following Newborn Hearing Screening Referrals

in Utah

Parental Satisfaction and Anxiety Following Newborn Hearing Screening Referrals

in UtahLinda D. Goetze, Catherine C. Groseclose, Scott Grosse,

Karl R. White, and Kay W. HansenEarly Intervention Research Institute

Utah State UniversityLogan, UT 84322-6580

[email protected]

Presented at:

National Early Hearing Detection and Intervention ConferenceWashington, DC

February 19, 2004

EIRIEIRI

Overall Project OutlineOverall Project Outline

Maintained cost web page: www.ehdicost.org

Family Survey—Completed Year 1 data collection activities and began Year 1 data analyses; began Year 2 data collection

Hospital Data Collection—Initial hospital cost and time diary data collection completed with 8 Utah hospitals; began hospital cost data analyses

Diagnostic Cost—Finalize methodology and sample, collect data

EIRIEIRI

Family SurveysFamily Surveys

Diagnostic survey FFF (n = 52)

Outpatient survey FFP (n = 37)

Inpatient survey FP (n = 44)

EIRIEIRI

Family Survey ResultsFamily Survey Results

Descriptives

Parental Satisfaction and Anxiety Cohort Differences– analysis of variance

– controlling for insurance differences, income,

and parents’ education

Results Summary

EIRIEIRI

34.7

102.1

330.5

0

100

200

300

400

Inpatient (FP) (n = 43)

Outpatient(FFP) (n = 37)

Diagnostic(FFF) (n = 49)

Mean Baby Stay in Hospital After Being Born

Ho

urs

Between Cohort Differences p < .01

EIRIEIRI

Percentage of Babies in NICU

Between Cohort Differences p < .001

0

10

20

30

40

50

Inpatient (FP) (n = 44)

Outpatient (FFP)(n = 37)

Diagnostic (FFF)(n = 52)

2%

14%

33%

EIRIEIRI

Percentage of Respondents Who Knew Baby was Screened for Hearing Loss

Between Cohort Differences n.s.

0

10

20

30

40

50

60

70

80

90

100

Inpatient (FP) (n = 44)

Outpatient (FFP)(n = 37)

Diagnostic (FFF)(n = 52)

98%

95%

100%

EIRIEIRI

Household Income Before Taxes(n = 119)

2 1

11

4

13

23

21

18

6 6

14

0

5

10

15

20

25

30

1 2 3 4 5 6 7 8 9 10 11

Nu

mb

er o

f C

ases

Mean = 6.8 (~ $35,000)

SD = 2.4

1 = Less than $5,0002 = $5,000 - $9,9993 = $10,000 - $14,9994 = $15,000 - $19,9995 = $20,000 - $24,9996 = $25,000 - $34.9997 = $35,000 - $44,9998 = $45,000 - $54,9999 = $55,000 - $64,99910 = $65,000 - $74,99911 = > $75,000

EIRIEIRI

Education of R and Partner(n = 133)

75

31

1 2

8

1

17

3 4

6

1

33

11

30

5

10

15

20

25

30

35

40

2.0 3.0 4.0 4.5 5.0 5.5 6.0 7.0 8.0 8.5 9.0 9.5 10.0 11.0 12.0

Nu

mb

er o

f C

ases

Mean = 7.1SD = 3.0

1 = Less than 12 years2 = High School Diploma3.5 = Technical Degree3.5 = 2 Year Associate Degree5 = College Degree6 = Graduate/Post-College

EIRIEIRI

Type of Insurance by Cohort

1

13

29

1

10

25

3

21

27

0

5

10

15

20

25

30

Inpatient FP (n = 43) Outpatient FFP (n = 36) Diagnostic FFF (n = 51)

No insurance n = 5 3.8% Medicaid n = 44 33.8%Private ins n = 81 62.4%

EIRIEIRI

4.56 4.57 4.86

1

1.5

2

2.5

3

3.5

4

4.5

5

Inpatient (FP) (n = 36)

Outpatient(FFP) (n = 37)

Diagnostic(FFF) (n = 51)

After all screening was complete, how did you feel...?

Mean Score: Glad hearing screening was done at this hospital

Between Cohort Differences n.s.

1 = Strongly disagree5 = Strongly agree

EIRIEIRI

3.19

4.08

3.34

1

1.5

2

2.5

3

3.5

4

4.5

5

Inpatient (FP) (n = 43)

Outpatient(FFP) (n = 36)

Diagnostic(FFF) (n = 50)

Tell us about your experience in getting the screening test while a patient at the hospital.

The screening test was carefully explained to me.

Between Cohort Differences p < .05

1 = Strongly disagree5 = Strongly agree

EIRIEIRI

3.51

2.583.06

1

1.5

2

2.5

3

3.5

4

4.5

5

Inpatient (FP) (n = 43)

Outpatient(FFP) (n = 36)

Diagnostic(FFF) (n = 50)

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital?

Very worried – Not worried

Between Cohort Differences p < .05

1 = Very Worried5 = Not Worried

EIRIEIRI

4.21 4.36

3.82

1

1.5

2

2.5

3

3.5

4

4.5

5

Inpatient (FP) (n = 43)

Outpatient(FFP) (n = 36)

Diagnostic(FFF) (n = 50)

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital?

Not Supported – Supported

Between Cohort Differences p .054

1 = Not supported5 = Supported

EIRIEIRI

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital?

Between cohort differences controlling for other variables p < .01

Average household income = 6.8Average education of R and partner = 7.1

4.654.65

4.04

5.21

4.24

4.38

3.37

3.38

3.94

1

1.5

2

2.5

3

3.5

4

4.5

5

5.5

6

Inpatient FP (n = 36) Outpatient FFP (n = 32) Diagnostic FFF (n = 42)

1 = Not Supported5 = Supported

Adjusted Means

No insurance n = 5Medicaid n = 36Private ins n = 69

EIRIEIRI

4.44

4.11

3.82

1

1.5

2

2.5

3

3.5

4

4.5

5

Inpatient (FP) (n = 43)

Outpatient(FFP) (n = 36)

Diagnostic(FFF) (n = 51)

Angry - Calm

Between Cohort Differences p < .01

1 = Angry5 = Calm

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital?

EIRIEIRI

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital?

Between cohort differences controlling for other variables p < .01

Average household income = 6.8Average education of R and partner = 7.1

5.05

4.77

4.28

5.03

4.63

3.81

3.33

3.79 3.71

1

1.5

2

2.5

3

3.5

4

4.5

5

5.5

6

Inpatient FP (n = 36) Outpatient FFP (n = 32) Diagnostic FFF (n = 42)

1 = Angry5 = Calm

Adjusted Means

No insurance n = 5Medicaid n = 36Private ins n = 69

EIRIEIRI

3.98

3.33

3.14

1

1.5

2

2.5

3

3.5

4

4.5

5

Inpatient (FP) (n = 43)

Outpatient(FFP) (n = 36)

Diagnostic(FFF) (n = 50)

Confused - Confident

Between Cohort Differences p < .01

1 = Confused5 = Confident

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital?

EIRIEIRI

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital?

Between cohort differences controlling for other variables p < .05

Average household income = 6.8Average education of R and partner = 7.1

5.05

4.68

3.62

4.02

3.43 3.25

1.67

3.143.13

1

1.5

2

2.5

3

3.5

4

4.5

5

5.5

6

Inpatient FP (n = 36) Outpatient FFP (n = 32) Diagnostic FFF (n = 42)

1 = Confused5 = Confident

Adjusted Means

No insurance n = 5Medicaid n = 36Private ins n = 69

EIRIEIRI

1.67

3.383.75

1

1.5

2

2.5

3

3.5

4

4.5

5

Inpatient (FP) (n = 43)

Outpatient(FFP) (n = 37)

Diagnostic(FFF) (n = 52)

After all screening was complete (before diagnosis was done), how did you feel?

Worried about my baby’s hearing.

Between Cohort Differences p < .000

1 = Strongly disagree5 = Strongly agree

EIRIEIRI

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital? Worried about my baby’s hearing.

Between cohort differences controlling for other variables p < .01

Average household income = 6.8Average education of R and partner = 7.1

1.95

1.61

3.9

3.27 3.04

3.65

3.73

3.82

1

1.5

2

2.5

3

3.5

4

4.5

5

5.5

6

Inpatient FP (n = 36) Outpatient FFP (n = 32) Diagnostic FFF (n = 42)

1 = Strongly disagree5 = Strongly agree

Adjusted Means

No insurance n = 5Medicaid n = 36Private ins n = 69

1.17

EIRIEIRI

4.444.32

3.44

1

1.5

2

2.5

3

3.5

4

4.5

5

Inpatient (FP) (n = 43)

Outpatient(FFP) (n = 37)

Diagnostic(FFF) (n = 52)

After all screening was complete (before diagnosis was done), how did you feel?

Confident about what to do next.

Between Cohort Differences p < .000

1 = Strongly disagree5 = Strongly agree

EIRIEIRI

Before you and your baby left the hospital, how did you feel when you were told your baby needed another screening after discharge from the hospital? Confident about what to do next.

Between cohort differences controlling for other variables p < .01

Average household income = 6.8Average education of R and partner = 7.1

4.75

4.38

5.11

4.514.16

3.01

3.16

3.49

1

1.5

2

2.5

3

3.5

4

4.5

5

5.5

6

Inpatient FP (n = 36) Outpatient FFP (n = 32) Diagnostic FFF (n = 42)

1 = Strongly disagree5 = Strongly agree

Adjusted Means

No insurance n = 5Medicaid n = 36Private ins n = 69

4.92

EIRIEIRI

$16.55

$14.27 $15.47

$-

$5

$10

$15

$20

$25

Inpatient (FP) (n = 14)

Outpatient(FFP) (n = 22)

Diagnostic(FFF) (n = 30)

How much do you earn per hour (before baby)?

Between Cohort Differences n.s.

EIRIEIRI

$22.25

$18.10

$12.50

$-

$5

$10

$15

$20

$25

Inpatient (FP) (n = 9)

Outpatient(FFP) (n = 13)

Diagnostic(FFF) (n = 21)

How much do you earn per hour (after baby)?

Between Cohort Differences p .059

EIRIEIRI

Family Survey Results SummaryFamily Survey Results Summary Overall respondent ratings of screening were positive

Respondents with babies diagnosed with hearing loss felt less supported, more worried, less confident, less calm, and more confused than respondents in the other cohorts.

Even after controlling for level of education, income, and insurance differences, these cohort differences remained.

When education, income, and insurance differences were included in the multivariate analysis, only the cohort was statistically significant in explaining parental satisfaction and anxiety.

Does this imply that the concerns about the negative effects of “false positive” impacts on families are negligible?

What can staff involved in screening and diagnosis do to improve how families feel about the process?

EIRIEIRI

Family Survey Results Summary (continued)Family Survey Results Summary (continued)

Differences were suggested in wage rate of respondents with diagnosed babies after the baby was born compared to families with babies who did not have a diagnosed hearing loss

….yet no significant differences in hourly wage between groups reported prior to the baby’s birth

All but one inpatient who did not return to work have very low hourly wage rates before baby was born (lower average income)

Data suggest that mothers with high wages and very low wages are less likely to return to work after their baby is born

At least two diagnosed who left work did so because of the baby’s diagnosis; one father of a diagnosed infant was fired because he spent “too much time at the hospital”

A larger sample may clarify reasons for the changes in hourly rates

EIRIEIRI

SuggestionsSuggestions

Suggestions about improvement of the project are welcome. Please email Dr. Linda Goetze about any suggestions for the cost study at:

E-Mail: [email protected]