Transcript Sample research poster - Tennessee Association of Drug

NEONATAL ABSTINENCE SYNDROME – A LOCAL INITIATIVE
Jana S. Chambers, M.S., R.D.
East TN Region NAS Sub-Committee, Cocke and Sevier County Health Departments NAS Pilot Project Teams
Introduction
Background
Contributing Factor:
Inpatient Hospitalizations for Any Diagnosis of NAS
Tennessee, 1999-2012
1000
2012
993 Hospitalizations
12.4/1,000 Live Births
900
Number of Hospitalizations
 Women on narcotics without a prescription for
contraceptive
14
800
12
10
700
600
8
500
6
400
1999
55 Hospitalizations
0.7/1,000 Live Births
300
200
4
Rate per 1,000 Live Births
Neonatal abstinence syndrome (NAS)
occurs when babies are exposed to
addictive drugs in the womb and
experience withdrawal after being
born. Nearly all drugs, whether illegal
or prescription drugs, cross the
placenta from the mother's blood
stream to the developing baby. This
means that whenever an expectant
mother is addicted to drugs, her
unborn baby also becomes addicted.
Once a baby is born, he or she no
longer receives that drug from the
mother and begins to experience the
painful symptoms of withdrawal.
Background
TennCare Women (15-44 years) on Narcotics without Contraceptive Rx
Tennessee Counties, 2012
Percent
68.7 - 72.7
72.8 - 78.4
2
78.5 - 82.1
100
82.2 - 84.7
0
0
84.8 - 89.3
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Number
Data Suppressed
Rate
Source: Division of Health Care Finance and
Administration, Bureau of TennCare.
Data sources: Tennessee Department of Health; Office of Health Statistics; Hospital Discharge Data System and Birth Statistical System.
Why the Concern?
NAS became a reportable disease in Tennessee on January 1,
2013.
Beyond the pain and suffering a newborn experiences,
NAS also has an economic and social impact.
Incidence:
TennCare NAS Costs
 At the close of the first reporting year, 28.1% of the total 855
cases of Neonatal Abstinence Syndrome (NAS) in Tennessee
occurred in the East Tennessee Rural Region.
CY 2011
 The East Region had a 22.9% increase in the number of NAS
cases when comparing data through week 34 for 2013 and
2014 while the increase statewide was 11.5%.
Cumulative Cases NAS Reported in the East Region
CY2013
CY2014
Background
177
Cases
200
144
Cases
180
Number of Cases
There was a 10-fold increase in NAS
babies born in Tennessee from 2000 to
2010 according to the state hospital
discharge database.
TennCare nonLBWT Births
NAS Infants
40,437
528
$171,336,964
$4,237
$33,249,612
$62,973
TennCare Infants Infants
in DCS Custody born in
Within 1 Year of CY 2011
Birth
Total # of Infants
55,578
528
Total # infants in
DCS
767
120
1.4%
22.7%
% in DCS
3.2
NAS
infants
32.5
Data source: Division of Health Care Finance
and Administration, Bureau of TennCare.
Objective
160
History:
Metrics
Number of
Births
Cost for Infant in
first year of life
Average Cost
per child
Average length
of stay (days)
DCS Involvement
140
120
To develop and implement a strategy to reduce the
likelihood that women would become pregnant while
using narcotics and thereby reduce the number of
infants born with NAS.
100
80
60
40
20
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Reporting Week #
21
22
23
24
25
26
27
28
29
30
31
32
33
34