Cost of Morbidities in Very Low Birth Weight Infants

Abstract

Objective The objective of this study was to determine the association between direct costs for the initial neonatal intensive care unit (NICU) hospitalization and four potentially preventable morbidities in a retrospective cohort of very low birth weight infants (VLBW; <1500g birth weight). Methods The sample included 425 VLBW infants born alive between July 2005 and June 2009 at Rush University Medical Center. Morbidities included brain injury, necrotizing enterocolitis, bronchopulmonary dysplasia, and late onset sepsis. Clinical and economic data were retrieved from the institution’s system-wide data warehouse and cost accounting system. A general linear regression model was fit to determine incremental direct costs associated with each morbidity. Results After controlling for birth weight, gestational age, and socio-demographic characteristics, the presence of brain injury was associated with a $12,048 (p=0.005) increase in direct costs; necrotizing enterocolitis with a $15,440 (p=0.005) increase; bronchopulmonary dysplasia with a $31,565 (p<0.001) increase; and late onset sepsis with a $10,055 (p<0.001) increase in direct costs. The absolute number of morbidities was also associated with significantly higher costs. Conclusions This study provides the first collective estimates of the direct costs during the NICU hospitalization for these four morbidities in VLBW infants. The incremental costs associated with these morbidities were high, and these data can inform future studies evaluating interventions to prevent or reduce these costly morbidities.

Outcomes and Costs of Surgical Treatments of Necrotizing Enterocolitis

“…15 The intrinsic costs of surgical NEC, or marginal costs, have been estimated to be between $22 328 and $198 040. 10,28 The intrinsic costs of surgical NEC thus account for a fraction of the total costs of care once comorbidities are accounted for. The equivalence in cost between patients treated with peritoneal drainage alone and laparotomy alone in this study is likely a result of using matched cohorts with equivalent comorbidity rates.…”

The Scope and Trends of Pediatric Hospitalizations in Texas, 2004–2010

“…The high cost of neonatal intensive care has been well described and comes as no surprise. 20,21 Hospitalizations for neonatal complications continue through the first year of life, costing $740 million annually. 22 The median hospitalization costs for infants with neonatal complications is .10 times higher than any other MDC in any of the age strata.…”

Survey of the Relationship Between Mother’s Chronic Diseases and Low Birth Weight in Infants, Ahvaz, South of Iran, 2014

“…According to the definition of low birth weight provided by world health organization (WHO), low birth weight (LBW) refers to the birth weight less than 2500 grams (2,3). Due to greater sensitivity, lower immunity and an increased risk family and community, impose great costs on different diseases (4). Studies have shown that more than 20 million babies, 15.5% of all the births worldwide, are annually born with low weight, and that amount is 18.6% in underdeveloped countries, 16.5% in developing countries, and 7% in the developed countries (2).…”

“…They suffer from extremely high rates of morbidity and mortality from infectious diseases and underweight, and stunting or wasting beginning in the neonatal period and lasting through childhood (6). LBW is a multi-causal phenomenon that economic, social, and cultural factors contribute to its development, but the factors associated with the mother and the baby are the most important ones (4). Many researchers consider the following factors very effective on LBW which have many negative consequences: maternal age less than 20 years and more than 35 years, maternal smoking during the pregnancy, gestational age less than 37 weeks, lack of weight gain during the pregnancy (5), multiple pregnancy, birth interval of less than 3 years, lack of supplements during the pregnancy (6), maternal chronic diseases (7-9), preeclampsia (10)(11)(12)(13), birth of children with low weight (3), premature birth (14,15), growth retardation intra uterine (16) the pregnancy (17)(18)(19), renal and heart disease (20,21), diabetes (22), sex of the neonate, inadequate antenatal care service utilization and unwanted pregnancy (23,24).…”

“…In addition, the normal-weight infants compared to these infants are more exposed to dangers such as cerebral palsy, mental retardation, neurological disabilities, respiratory diseases, sudden death syndrome and complications of hospitalization in the intensive care unit (3,15,25). Low birth weight is also associated with immune system disorder, malnutrition, poor cognitive development and increased risk of diarrhea or acute pneumonia (4). According to the findings, these infants have poor growth in childhood, and are more susceptible to diseases such as hypertension, cardiovascular disease, type 2 diabetes stroke (2, 4), obesity and chronic disease (26), after puberty.…”