Am J Perinatol
DOI: 10.1055/a-2190-8288
Original Article

Effect of Health Insurance Status and Visitation Restrictions on Virtual Visitation Technology in the Neonatal Intensive Care Unit

Beatrice M. Stefanescu
1   Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
Susan E. Henderson-Sears*
1   Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
Andrei R. Stefanescu*
2   Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
Jayme D. Allen
1   Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
› Author Affiliations
Funding None.


Objective This study aimed to examine the relationship between virtual technology system utilization and insurance status or type of visitation restrictions in a single-center neonatal intensive care unit.

Study Design Prospective cohort study with separate analyses performed based on insurance status (public vs. nonpublic) and “in effect” unit visitation restrictions. The three study epochs based on patient visitation restrictions were Epoch 1 (July to October 2019) with standard visitation restrictions, Epoch 2 (November 2019 to February 2020) with respiratory syncytial virus/influenza visitation restrictions, and Epoch 3 (March to June 2020) with coronavirus disease 2019 (COVID-19) visitation restrictions, respectively.

Results Families of 357 infants used web-based cameras through most of the infant's hospitalization (median: 86.05%, Q3: 97.9%) with 165,795 total camera logins, indicating consistent utilization. There was a trend for fewer logins per infant and significantly longer time to consent (p = 0.03) in the Public Insurance group. Unit visitation restrictions impacted the time to consent, the shortest being in Epoch 3 during the COVID-19 pandemic (p = 0.03).

Conclusion Virtual visitation technology is well embraced by neonatal instensive care unit families; however, gaps in access and use among subgroups signals a form of social inequality that needs to be explored further.

Key Points

  • Virtual visitation technology can bridge the distance gap for families of hospitalized infants.

  • Utilization of virtual technology is affected by socioeconomic factors and seasonal unit visitation restrictions.

  • Factors influencing disparities in access and utilization of virtual technology need to be investigated further.

Data Availability

The data generated and analyzed during the current study are not publicly available through a repository but are available from the corresponding author on reasonable request and may require institutional data agreements.

Authors' Contributions

B.M.S. was responsible for the study concept. All authors took part in the design of the study. All authors wrote part of the manuscript, gave feedback, and made modifications to the manuscript. Statistical analysis was performed by A.R.S. All authors had access to the study data, reviewed the results, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work.

* These authors contributed equally to this work.

Publication History

Received: 14 November 2023

Accepted: 11 October 2023

Accepted Manuscript online:
12 October 2023

Article published online:
08 November 2023

© 2023. Thieme. All rights reserved.

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