Outpatient healthcare access and utilization for neonatal abstinence syndrome children: A systematic review

Adam Van Horn, Whitney Powell, Ashley Wicker, Anthony D. Mahairas, Liza M. Creel, Matthew L. Bush

Research output: Contribution to journalReview articlepeer-review

3 Citations (SciVal)


Objective: The objective of this study was to systematically assess the literature regarding postnatal healthcare utilization and barriers/facilitators of healthcare in neonatal abstinence syndrome (NAS) children. Methods: A systematic search was performed in PubMed, Cochrane Database of Systematic Reviews, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science to identify peer-reviewed research. Eligible studies were peer-reviewed articles reporting on broad aspects of primary and specialty healthcare utilization and access in NAS children. Three investigators independently reviewed all articles and extracted data. Study bias was assessed using the Newcastle-Ottawa Assessment Scale and the National Institute of Health Study Quality Assessment Tool. Results: This review identified 14 articles that met criteria. NAS children have poorer outpatient appointment adherence and have a higher rate of being lost to follow-up. These children have overall poorer health indicated by a significantly higher risk of ER visits, hospital readmission, and early childhood mortality compared with non-NAS infants. Intensive multidisciplinary support provided through outpatient weaning programs facilitates healthcare utilization and could serve as a model that could be applied to other healthcare fields to improve the health among this population. Conclusions: This review investigated the difficulties in accessing outpatient care as well as the utilization of such care for NAS infants. NAS infants tend to have decreased access to and utilization of outpatient healthcare following hospital birth discharge. Outpatient weaning programs have proven to be effective; however, these programs require intensive resources and care coordination that has yet to be implemented into other healthcare areas for NAS children.

Original languageEnglish
Pages (from-to)389-397
Number of pages9
JournalJournal of Clinical and Translational Science
Issue number5
StatePublished - Oct 2020

Bibliographical note

Funding Information:
MLB is a consultant for MED-EL and Stryker and has received research funding from Advanced Bionics (unrelated to this research). The authors have no other financial relationships or conflicts of interest to disclose pertaining to the manuscript.

Funding Information:
This work was supported by the National Institute of Deafness and Other Communication Disorders (1K23DC014074) (MLB) and the National Institute of Health/National Center for Advancing Translational Sciences (UL1TR000117) (WP).

Publisher Copyright:
© The Association for Clinical and Translational Science 2019.


  • healthcare access
  • healthcare utilization
  • Neonatal abstinence syndrome

ASJC Scopus subject areas

  • General Medicine


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