Under ideal circumstances, after they welcome a new addition to the family, two healthy (if terrified) parents head home from the hospital with an equally healthy newborn. But wouldn’t it be great if they could take home a nurse, too, just in case?
Researchers at Duke University have found that families who receive postnatal nurse home visits show a 59 percent drop in emergency room trips, more positive parenting behaviors, a safer home environment, and lower rates of parental anxiety.
The researchers say that for every dollar spent on nurse visits for newborns, three dollars in healthcare costs are ultimately saved.
Postnatal home visiting programs aren’t unheard of: The Patient Protection and Affordable Care Act, better known as Obamacare, provides for them to the tune of $1.5 billion under the “Maternal, Infant, and Early Childhood Home Visiting Program.”
The assumption is that these funds will be used to provide visits for at-risk families. But the Duke researchers have found that, for any family, a short term home visiting program can improve their home environment as well as cut costs.
The Duke study, uses data from a postnatal home visiting program called Durham Connects in North Carolina, and is the first randomized controlled trial of such a program across a universal study population. It included 531 families who had given birth between July 2009 and December 2010 in Durham County.
“Other evidence-based home visiting programs have shown a positive return on investment, but typically that return is realized over a period of years rather than months,” said study author Benjamin Goodman, Ph.D. His findings suggest that by the age of six months, the birthing hospital could “recoup program costs three times over” by utilizing nurse home visits.
“Identifying a positive return on investment in such a short period of time is very encouraging, and suggests that offering newborn nurse home visits to all families could be an important strategy for reducing long-term healthcare costs,” Goodman said.
Hospital Care, Delivered
The Durham Connects program consisted of an initial meeting just after the baby's birth to explain the program and the benefits of home visits. After this come one to three nurse home visits between the third and twelfth weeks after birth, one to two nurse contacts with a service provider, and a staff member telephone or home follow-up one month later.
A nurse home visit can make all the difference, because the nurse can see the family in their own environment, asses risks unique to each family, and offer oversight, even if it’s as simple as providing reassurance that parents are doing a good job.
Common misconceptions about home visiting programs, said Goodman, are that they need to be long-term in order to be effective. Such programs are also often perceived as only benefiting certain demographics, like low-income or single parent families. These findings demonstrate that a brief home visiting program, within six months of birth, can be of help to any family.
Moving Beyond Durham
Researchers are already looking beyond Durham to expand home visiting programs. “The program was designed to be transportable," Goodman said. "Although the Connects model has only been evaluated in Durham thus far, the program will soon begin in four rural counties in eastern North Carolina.”
New parents, and even parents who are on a second, or third, or fourth child, will inevitably have questions, Goodman said. “We hope that clinicians, healthcare companies, and families will recognize the important benefits that newborn nurse home visiting can have,” he said.
One day, it’s possible that these programs will be the standard of care for all U.S. infants.