AA DESIGN OF A CLINICAL COMPUTER DATABASE FOR A NEONATAL PA POST-PARTUM EXTENDED MATERNAL-INFANT CONTACT: SUBSE- L)Y INTENSIVE CARE UNIT (NICU). Michael Maurer, Charles Mead. Janet Johnson, Edward Bartlet t , ~obert- Brouillette. Wm. Stratton and Richard Marshall (Spon. by Harold Zarkowsky) Washington Univ. Sch. of Med.. Dept. of Pediat.. Bio- medical Computer Lab.. St. Louis. Mo. 63110 Hospitalization in a NICU averages 1 mo. but may extend to 8-9 mos. Voluminous amounts of data makes it difficult to systemati- cally study disease processes with the conventional medical rec- ord. A computer system is being developed to aid in the analysis of the incidence, course, interrelationships and demographic fea- tures of the various newborn illnesses seen in a referral NICU averaging 600 sdmissions/year. How does this computer system pro- vide information about newborn problems which would otherwise be difficult to acquire? Each infant's database is divided into 4 categories: 1) Admission history and physical exam 2) In-hospital clinical events 3) Laboratory data 4) Outpatient follow-up. Com- plete information from each category is entered into separate com- puter files. Information is assessed via bit-mapped (inverted) files which allow acquisition of single or multiple pieces of data comaon to some subset of the total of patients. Laboratory data collected on a daily basis is available for analysis as an inter- face with clinical data. These file structures favor rapid searches of the entire database but will still permit display of all or part of an individual patient's complex hospital course. The major advantage of this system is that it permits the user to explore rapidly a large number of possibly signlflcant relstion- ships in a large population of newborn infants. 50 CLASSROOK ~WAG~ENT OF CHILDREN WITH LZUK~IA - T.D. liale, P.J. Barnard, N.B. Na.iar, Introd. by C. L. Schiebler, University of r'lorida, ~einesvilld, F1.32610 A team comprised of physicians, physician-assistants, and a sooial worker visited 14 schools and 117 educetore of 13 children with leukemia ages 5-17). 55/117 of the educators were direotly involved !Croup I), others were principals oounselors, coaches (Croup 11). 21/55 in Cr. I and 45/62 in Cr. I1 were previously unaware of the child's diagnosis. 18/34 of Gr. I and 12 45 in Cr. I1 were informed by parents. . 15/55 in Dr. I nnd 3/d2 in Dr. TI had oou~htadditional in- formation previously from books (13). health professionals (3) end periodicals (2). 15/55 in Cr. I and 10/62 in Cr. I1 were unaware that long-term survival was a possibility in childhood leukemia. 115/117 in both groups requested addit- ional inforne tion. Therefore, an uudiovisual self-instructional program was prepared end field-tested with 73 of these same educators, as well as 36 adolescent classmetee. This program consisted of s pemphlat, 3 5 m slides, caseette-tape end a structured questionnaire. 26/73 responding educators end 26/36 claes- mates wished the program expanded to cover the following topics: survival (lo), physical education (7), infectious disease exposure (3). alopecia (3), side-effects of nedicet- ions (7). weight gain (2). of the leukemia children were schievine ebove-average ma&131 was cnnsidered logifted'' nnd 1 was below his age- le el' No dominant theme. were discerned in the d anines wrrti~gs, behavior, or music of the children with feakemi~. PEDIATRICIANS' AWARENESS OF HOSPITAL COSTS. Phillip 51 I. Nieburn. Howard L. Weinberner. and Arthur M. Stockmen, (Spon. bv Frank A. Oski), Dept. of Peds., SUNY, Upstate Medical Center. Svracuse, N.Y. Health care costs are a focus of increasing discussion and debate in medical and lay circles. There have been few efforts to assess physician awareness of such costs. We have evaluated awareness of actual hospitalization charges (HC) by 27 pediatric house officers (PL). 29 pediatricians in practice (PP) and 14 full time pediatric faculty (FAC). Case histories reflecting all HC and physician charges were prepared from 4 representative pediatric admissions (croup, meningitis. dehydration, premature neonate). PL, PP, and FAC were asked to estimate HC in various categories: total bill, room charge, laboratorv studies, med- ications. IV fluids and physicians fees. Results indicate: 1) FAC most accurately estimated total HC. 2) More than half of each group was within + 30% of the actual total bills for 3 of 4 cases. 3) All 3 groups markedly underestimated room charges and total HC for the premature neonate; PP underestimates exceeded PL or FAC. 4) All groups attributed an amount of HC to medications and IV fluids in excess of actual amounts. 5) All groups estimated laboratory test fees with equivalent accuracy; large underestimates were common. 6) Although most physicians expressed interest in seeing copies of their patients hospital bills, few, if any, now do so. Our results indicate wide variation in awareness of various aspects of HC bv phvsicians. Efforts to increase such awareness should he encouraged. 34 QUENT MOTHERING AND CHILD HEALTH. Susan M. O'Connor, Peter M. Vietze, John B. Hopkins. William A. Altemeier Vanderbilt University. Nashville General Hospital. Department of Pediatrics, and peabody College for ~eachers;~e~irtment of Psy- chology, Nashville, Tennessee. In a double-blind study, 301 low-income primiparous women were randomly assigned to rooming-in (RI) or control (C) post-partum (PP) beds. C mother-infant dyads (N-158) were together for 20 minutes every 4 hours for feedings during the first 2 PP days; RI dyads (N-143) were together 6 additional hours each day. Duration of data collection from medical and agency records after delivery (12-21 months) is equivalent between the 2 groups, as are the descriptive data. Analysis is based upon 134 RI and 143 C dyads; 9 RI (6%) and 15 C (9.5%) were lost to follow-up. RI and C children did not differ in average age, frequency of outpatient visits, or frequency of well baby or acute illness diagnoses. No RI and 6 C (4%) were seen for either pertussis or the common exanthematous diseases of childhood (pc0.05). One RI and 9 C (6%) experienced parenting failure (PF) (pc0.05); no RI and 8 C were hospitalized for PF (pc0.01). No RI and 9 C exper- ienced abuse, neglect, abandonment or nonorganic fsilure-to- thrive (pc0.01). One RI and 5 C were referred to social agen- cies for possible child maltreatment. No RI and 5 C children either died (1) or experienced foster care (pc0.05). Extended post-partum maternal-infant contact may benefit sub- sequent mothering and child health. 53 THE EFFECTS OF THERAPY ON THE DEV-AL SCORES OF IRON DEPICIMT 1:RAWK. Frank A. Oski and Alice M. Honi . SUNY. Upstate Medical Center, and the College of Human Deklopmcnt, Syracuse Univ.. Syracuse. N.Y. It has been proposed that iron deficiency in infants and children is associated with behavioral alterations. To test this hypothesis. 24 infants with iron deficiency anemia, ales 9 to 26 nos, were randody assigned to s treatment and control group. Bayley Scales of Infant Developpant were administered before the institution of treatment with intramuscular iron or placebo and the test was readministered in 5 to 8 days. Mean hemo~lobinlevel in the 2 groups was minilar. It avarauad 8.6 in the controls and 8.7 gmldl in the treatment group. The 2 groups did not differ with reapect to a8a. sex. racial com- position. or Initial Bayley scores of Mental Devalopment Index or Physical Development Index. Infants treated with iron showed a statistically significant (p - .01) increase in their score. on the Mental Doveloplant Index averapring a man pain of 13.6 points in a oean time. of 6.R days. No changes were observed in the control group. Tha treated group was also found to become more alert and responsive and demonstrated improvement in tests of gross and fine motor coordination. All improvemnt occurred indspendent of signifi- cant increases in henoqlobin level. These findings support the hypothesis that iron deficiancy. and not anemia, in infants produces developmental alteratiom and that these changes are rapidly reversihle with iron therapy. Pedbtricli, Mar. 'ihr direct costs of train* child lrdtll n s m h t e s were rktemhed hr nnrtbminp the nctunl exnmnes for a seven vear mid (.Tulv, 1968 - .hme, 1975) of the tl-re?-:war, IMversity of Cnlornda Sc!ml of ?'edicine'n Child Ik?nltli hssocinte Propcm. bsts ttwc nllocntrd into six r~tgoriea: start-up, teachinp, n~otration, pvaluntim, h l n m t and shlc'ent s mt. 'llle mts tme cnlculntrd ner trainee (PI - 61) per year of trininp. ?In? esthtd t?.m ment r*~ th fandty in mkdnistrative, teach- inp md rrrrearrh activitics r.m alsn tktemined. hhinintmt'vc ant! teacM.np exnarses of the Odld I-hlth hsmintr Proprm 1.- Shti55/~tudmt/venr. Start-up, evaluation, hlmt ml sttulent mmrt m t s totnlec! S 38~8ls~tl~. Cmcluniai: r)iild balth rvlsocintes are fully prepared to di~pnose wc' treat mre than Qn" of d-ulatory dintric patients nt a cost of 1.~4~ than mr-t!iird the Tse of educatinp a nculintri.cim to wrfom thr s m fimctims imd activities. A rntiml !~mltll plmni~ noliqr d.cultl include the extmive utilization of child !wcllth associates as primRy hc~lth cmc nrvl.dern for d.il&en.