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Results in a Randomized Trial of Early Intervention

Marie C. McCormick, MD, ScD; Jeanne Brooks-Gunn, PhD; Sam Shapiro; April A. Benasich, PhD; George Black; Ruth T. Gross, MD

JAMA. 1991;265(17):2212-2217.

Abstract
Exposure of young children to group day-care settings increases the risk of illness and may result in higher use of medical care. These observations raise concerns that the use of such settings for early intervention programs for low—birth-weight infants may increase the already high burden of medical care costs incurred by these children and their families. To address the question of medical care use associated with center-based care, we examined the hospital-based and ambulatory care reported for participants of the Infant Health and Development Program. This project is a multisite randomized trial of an early intervention program for preterm low—birth-weight infants with an intervention including 2 years of center-based care. The Intervention group did not differ in hospital-based care and averaged only two more physicians' visits over the 3-year observation period than the comparison group. We conclude that early intervention programs involving high-quality group care are not accompanied by substantial increases in health care use.

(JAMA. 1991;265:2212-2217)

Author Affiliations
From the Infant Health and Development Program, Stanford, Calif (Drs McCormick, Brooks-Gunn, Benasich, and Gross and Messrs Shapiro and Black); Division of Neonatology, Department of Pediatrics, Harvard Medical School, Boston, Mass (Dr McCormick); Educational Testing Service, Princeton, NJ (Dr Brooks-Gunn); Health Services Research and Development Center, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Md (Mr Shapiro); and Center for Molecular and Behavioral Neuroscience, Rutgers, the State University, Newark, NJ (Dr Benasich).

Footnotes
A preliminary version of this report was presented at the American Pediatric Society—Society for Pediatric Research—Ambulatory Pediatric Association meetings, May 8,1990, Anaheim, Calif, and published in abstract form in Pediatric Research (1990;27:249).

Reprint requests to Joint Program in Neonatology, The Children's Hospital, 300 Longwood Ave, Boston, MA 02115 (Dr McCormick).

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