Measuring economic consequences of preterm birth - Methodological recommendations for the evaluation of personal burden on children and their caregivers

Abstract

This study aims to identify the impact of a preterm birth on financial and emotional burden from the families' perspective. Additionally, a comprehensive schedule of recommendations for a sufficient evaluation of all aspects of burden is developed. Based on the results of a literature search relevant categories and sub-domains for a questionnaire covering multiple aspects of associated financial and emotional burden are identified and converted into a recommendation scheme. Results of the literature search illustrate the large extend of burden of prematurity on parents. This results in substantial out-of-pocket expenditures (OOPE) and emotional distress to the parents besides the medical problems and further financial costs to the health insurance system. According to the results on infants' state of health, OOPE and emotional distress are significantly increased with decreasing gestational age. OOPE for transportation often amounts to the main parental cost dimension. Moreover there is some evidence for a high magnitude of reduced income and missed work days. The family perspective has to be taken into account when calculating the overall costs of preterm births from a societal point of view. However, in recent years economic evaluations were performed rather inhomogeneously in this field. For future studies a) direct medical costs, b) direct non-medical costs, c) indirect costs as well as d) intangible costs (in terms of emotional distress and reduced quality of life for caregivers and children) are the main categories that should be evaluated measuring personal burden of preterm birth on families adequately. A detailed list of specific sub-domains is given. Additionally, the recommendations are not restricted to application in infants born preterm and/or at low birth weight.

The Consequences of Chorioamnionitis: Preterm Birth and Effects on Development

“…The cost of caring for individual infants varies according to their gestational age [18], with care for an extremely preterm infant reaching ~US$250,000 [10]. …”

Targeted Health Department Expenditures Benefit Birth Outcomes at the County Level

“…Increases in morbidity related to low birth weight (LBW) contributes to high direct medical costs, 25–28 non-medical costs such as higher child care expenses, 29 and less tangible costs such as the burden of caregiving to families. 30,31 Recent studies using national data sets have identified linkages between general LHD spending and broad, distal mortality outcomes and related disparities. 32,33 Based on these studies and another indicating that MCH-specific services provided by LHDs are linked to reductions in mortality disparities, 2 this study used unique, detailed data obtained through a two-state consortium of Public Health Practice-Based Research Network (PBRN) partners to examine impacts of MCH-related spending by LHDs on birth outcomes.…”

Relationship among Maternal Height, Pre-Pregnancy Nutritional Status and Birth Weight of Neonates in Dhaka City

“…6,7 In addition, LBW is considered as a universal threat for developing countries that creates a barrier for child development. 8,9 Other studies have shown several factors to be determinants of LBW and have demonstrated that preventing those factors can help reduce early childhood morbidity and mortality.…”

“…5 Furthermore, with the demographic change of increased life expectancy at birth in developing countries, children born with LBW can cause an increased economic burden and an increased disease burden. 6,7 In addition, LBW is considered as a universal threat for developing countries that creates a barrier for child development.…”