Date of Award


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Annie N. Simpson

Second Advisor

Kit N. Simpson

Third Advisor

Brittany Hand


Purpose: Empirical investigation is needed to better understand how utilization of speech pathology (SLP) and occupational therapy (OT) services are associated with subsequent health outcomes in preterm infants with feeding disorders. Method: Using logistic regression, we conducted a retrospective cohort analysis of preterm babies with feeding disorders who received SLP or OT using 2013-2015 Medicaid administrative data provided via Truven MarketScan database. Covariates included gender, race, birthweight, and length of stay. Outcome variables were any hospitalization for failure to thrive (FTT) claims six to eighteen months after discharge from the NICU. Results: Retrospective cohort analysis of 6,190 premature babies were analyzed; 54% were boys, and 42% percent were white of non-Hispanic descent. Seven percent of the babies with feeding disorders had a claim for any therapy. Ten percent of infants who received therapy during the exposure period were hospitalized with a diagnosis code for FTT. Data analysis revealed premature infants with feeding disorders who received any SLP or OT services were more likely to be hospitalized with a diagnosis of FTT (OR = 1.93 95% CI 1.33 – 2.76). Total eighteen-month mean costs were $52,538 for children born premature with feeding disorders who received any therapy. Conclusions: In this publicly-insured sample of premature infants with feeding disorders, receiving SLP or OT services increased the probability of hospital admission for FTT. Findings may reflect a severely ill cohort of infants who received therapy services. Further investigation is warranted to identify treatment protocols which can prevent hospitalizations and reduce costs in this focalized population.


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