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
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]
Top Related