PEDIATRICS Vol. 117 No. 1 January 2006, pp. 154-160 (doi:10.1542/peds.2005-0484)
ARTICLE |
Costs of Newborn Care in California: A Population-Based Study
a Health Economics Resource Center
b Center for Health Care Evaluation
c Cooperative Studies Program, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
d Department of Health Research and Policy, Stanford University, Stanford, California
OBJECTIVE. We sought to describe the current costs of newborn care by using population-based data, which includes linked vital statistics and hospital records for both mothers and infants. These data allow costs to be reported by episode of care (birth), instead of by hospitalization.
METHODS. Data for this study were obtained from the linked 2000 California birth cohort data. These data (n = 518704), provided by the California Office of Statewide Health Planning and Development (OSHPD), contain infant vital statistics data (birth and death certificate data) linked to infant and maternal hospital discharge summaries. In addition to the infant and maternal hospital discharge summaries associated with delivery, these data include discharge summaries for all infant hospital-to-hospital transfers and maternal prenatal hospitalizations. The linkage algorithm that is used by OSHPD in creating the linked cohort data file is highly accurate. More than 99% of the maternal and infant discharge abstracts were linked successfully with the birth certificates. These data were also linked successfully with the infant discharge abstracts from the receiving hospital for 99% of the infants who were transferred to another hospital. The hospital discharge records were the source of the hospital charges and length-of-stay information summarized in this study. Hospital costs were estimated by adjusting charges by hospital-specific ratios of costs to charges obtained from the OSHPD Hospital Financial Reporting data. Costs, lengths of stay, and mortality were summarized by birth weight groups, gestational age, cost categories, and types of admissions.
RESULTS. Low birth weight (LBW) and very low birth weight (VLBW) infants had significantly longer hospital stays and accounted for a significantly higher proportion of total hospital costs. The average hospital stay for LBW infants ranged from 6.2 to 68.1 days, whereas the average hospital stay for infants who weighed >2500 g at birth was 2.3 days. Overall, VLBW infants accounted for 0.9% of cases but 35.7% of costs, whereas LBW infants accounted for 5.9% of cases but 56.6% of total hospital costs. Although total maternal and infant costs were similar (
$1.6 billion), the distribution of maternal costs was much less skewed. For infants, 5% of infants accounted for 76% of total infant hospital costs. Conversely, the most expensive 3% of deliveries accounted for only 17% of total maternal costs.
CONCLUSIONS. The very smallest infants make up a hugely disproportionate share of costs; more than half of all neonatal costs are incurred by LBW or premature infants. Maternal costs are similar in magnitude to newborn costs, but they are much less skewed than for infants. Preventing premature deliveries could yield very large cost savings, in addition to saving lives.
Key Words: neonatal care • NICU • health care costs
Abbreviations: LBW—low birth weight • VLBW—very low birth weight • OSHPD—Office of Statewide Health Planning and Development • LOS—length of stay
Accepted Jun 30, 2005.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  S. R. Hintz, C. M. Bann, N. Ambalavanan, C. M. Cotten, A. Das, R. D. Higgins, and for the Eunice Kennedy Shriver National Institute Predicting Time to Hospital Discharge for Extremely Preterm Infants Pediatrics, January 1, 2010; 125(1): e146 - e154. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Korvenranta, L. Lehtonen, M. Peltola, U. Hakkinen, S. Andersson, M. Gissler, M. Hallman, J. Leipala, L. Rautava, O. Tammela, et al. Morbidities and Hospital Resource Use During the First 3 Years of Life Among Very Preterm Infants Pediatrics, July 1, 2009; 124(1): 128 - 134. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The EXPRESS Group One-Year Survival of Extremely Preterm Infants After Active Perinatal Care in Sweden JAMA, June 3, 2009; 301(21): 2225 - 2233. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. R. Waters, S. S. Foldes, N. L. Alesci, and J. Samet The Economic Impact of Exposure to Secondhand Smoke in Minnesota Am J Public Health, April 1, 2009; 99(4): 754 - 759. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. K. McLaurin, C. B. Hall, E. A. Jackson, O. V. Owens, and P. J. Mahadevia Persistence of Morbidity and Cost Differences Between Late-Preterm and Term Infants During the First Year of Life Pediatrics, February 1, 2009; 123(2): 653 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Mangham, S. Petrou, L. W. Doyle, E. S. Draper, and N. Marlow The Cost of Preterm Birth Throughout Childhood in England and Wales Pediatrics, February 1, 2009; 123(2): e312 - e327. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. E. Tyson, N. A. Parikh, J. Langer, C. Green, R. D. Higgins, and the National Institute of Child Health and Human D Intensive Care for Extreme Prematurity -- Moving beyond Gestational Age N. Engl. J. Med., April 17, 2008; 358(16): 1672 - 1681. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. B. Russell, N. S. Green, C. A. Steiner, S. Meikle, J. L. Howse, K. Poschman, T. Dias, L. Potetz, M. J. Davidoff, K. Damus, et al. Cost of Hospitalization for Preterm and Low Birth Weight Infants in the United States Pediatrics, July 1, 2007; 120(1): e1 - e9. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Clements, W. D. Barfield, M. F. Ayadi, and N. Wilber Preterm Birth-Associated Cost of Early Intervention Services: An Analysis by Gestational Age Pediatrics, April 1, 2007; 119(4): e866 - e874. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Haberland, C. S. Phibbs, and L. C. Baker Effect of Opening Midlevel Neonatal Intensive Care Units on the Location of Low Birth Weight Births in California Pediatrics, December 1, 2006; 118(6): e1667 - e1679. [Abstract] [Full Text] [PDF]
|
|
