The economic burden of prematurity in Canada

Abstract

BackgroundPreterm birth is a major risk factor for morbidity and mortality among infants worldwide, and imposes considerable burden on health, education and social services, as well as on families and caregivers. Morbidity and mortality resulting from preterm birth is highest among early (< 28 weeks gestational age) and moderate (28–32 weeks) preterm infants, relative to late preterm infants (33–36 weeks). However, substantial societal burden is associated with late prematurity due to the larger number of late preterm infants relative to early and moderate preterm infants.MethodsThe aim in this study was to characterize the burden of premature birth in Canada for early, moderate, and late premature infants, including resource utilization, direct medical costs, parental out-of-pocket costs, education costs, and mortality, using a validated and published decision model from the UK, and adapting it to a Canadian setting based on analysis of administrative, population-based data from Québec.ResultsTwo-year survival was estimated at 56.0% for early preterm infants, 92.8% for moderate preterm infants, and 98.4% for late preterm infants. Per infant resource utilization consistently decreased with age. For moderately preterm infants, hospital days ranged from 1.6 at age two to 0.09 at age ten. Cost per infant over the first ten years of life was estimated to be $67,467 for early preterm infants, $52,796 for moderate preterm infants, and $10,010 for late preterm infants. Based on population sizes this corresponds to total national costs of $123.3 million for early preterm infants, $255.6 million for moderate preterm infants, $208.2 million for late preterm infants, and $587.1 million for all infants.ConclusionPremature birth results in significant infant morbidity, mortality, healthcare utilization and costs in Canada. A comprehensive decision-model based on analysis of a Canadian population-based administrative data source suggested that the greatest national-level burden is associated with moderate preterm infants due to both a large cost per infant and population size while the highest individual-level burden is in early preterm infants and the largest total population size is in late preterm infants. Although the highest medical costs are incurred during the neonatal period, greater resource utilization and costs extend into childhood.

The lived experience of fathers of preterm infants in the Neonatal Intensive Care Unit: a systematic review of qualitative studies

“…), dramatically contributing to the health costs in North American states (Johnston et al . ). Even in absence of clinical risk and injuries for the newborn, the hospitalisation of a preterm newborn in the highly medical Neonatal Intensive Care Unit (NICU) is a challenging and distressful experience for the parents.…”

Changing definitions of long-term follow-up: Should “long term” be even longer?

“…132–134 A large population based Canadian study 134 of PT infants followed for 10 years identified that although the majority of subjects remained in their 2 year disability category, there were shifts. Early PT had a decrease in the percent with severe disability, with a small shift from moderate and severe to no or mild disability.…”

Stem Cells

“…The damaging and often permanent effects related to these newborn insults are associated with high economic and societal costs, while the personal suffering of the afflicted and their families is incalculable 80;81 . Thus, the successful prevention or treatment of insult-related injury is of utmost and immediate importance.…”