Nurse Home Visits Help Infants, Save Dollars

Dodge Honored for Durham Connects Role

Center Director Kenneth Dodge ha_Dodge_1801s been honored with a Spotlight Award from the Network of Schools of Public Policy, Affairs and Administration (NASPAA), for his work helping to develop the Durham Connects nurse home visiting program.

The Spotlight Awards honor outstanding contributions toward solving public sector problems. Honorees were announced November 6 during the association’s annual conference in Albuquerque.

George Dougherty, Jr. of the Graduate School of Public and International Affairs at the University of Pittsburgh chaired the awards selection committee.

“The nominees have made great contributions to their communities and demonstrate the ideals of public service,” Dougherty said. “It is a pleasure for us to highlight their contributions.”

Other award recipients included Ester Fuchs of Columbia University’s School of International and Public Affairs, Molly Lipscomb of the University of Virginia’s Frank Batten School of Leadership and Public Policy and Michael Sorrell, president of Paul Quinn College and a former member of the Sanford School of Public Policy Board of Visitors. Watch Video

 

Durham Connects Saves Dollars, Helps Newborns

Nurse home visits Durham Connects Nurse Liz Stevensto newborns and their families lead to sharp declines in emergency care use and to health care cost savings, according to two recent studies. For every $1 spent on Durham Connects‘ nurse home visiting for newborns, $3 were saved in health care costs. The home visiting program more than paid for itself within the infants’ first six months of life.

A study in the American Journal of Public Health says infants in the Durham Connects nurse home visiting program used 59 percent less emergency care in the first six months of life. A second study in Pediatrics finds that Durham Connects’ benefits continue throughout the first year of life, with participating infants using 50 percent less emergency care than other babies. The reductions held true for all subgroups studied, including single- and two-parent families, families receiving Medicaid and privately insured families. The research was conducted by Center director Kenneth Dodge, Ben Goodman and others.

“Everyone is concerned about healthcare costs,” Dodge said. “Nurse home visiting programs can prevent inappropriate use of emergency medical care for infants. They represent a cost-effective ways to help young families get off to a good start.”

Durham Connects takes an unusual approach to nurse home visiting, through a brief, large-scale program designed to triage problems and connect new parents with community resources. It offers nurse home visits to every newborn in Durham County, North Carolina. In addition to providing health checks and other services, nurses encourage families to develop strong relationships with pediatricians, and not to visit the emergency room for primary care.

By reducing emergency care episodes, the authors estimate that Durham Connects saved thousands of health care dollars. Compared with estimated costs of $423 per emergency outpatient visit and $3,722 per hospital night cited by this study, the Durham Connects program costs $700 per family. Based on those findings, the authors estimate that for cities of similar size averaging 3,187 births per year, an annual investment of approximately $2.2 million in nurse home visiting would yield community healthcare cost savings of about $6.7 million in the first six months of life, or $3 saved for every $1 spent.

In addition to saving on emergency room care, the program improved health and parenting outcomes. Participating families had lower rates of maternal anxiety and higher-quality home environments: Their homes were more likely to be safe, clean and free of hazards, and to include more age-appropriate books and toys. They showed more positive parenting behaviors, such as comforting or reading to their child. Also, if the parents chose out-of-home child care, they chose higher-quality care.

Durham Connects was launched by the Duke University Center for Child and Family Policy in cooperation with the Durham County Health Department and the Center for Child & Family Health. It is now operated by the Center for Child & Family Health.

This trial has been registered as the “Durham Connects Evaluation” with ClinicalTrials.gov, NCT01406184, http://www.clinicaltrials.gov. Funding was provided by the Duke Endowment

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