Published online March 5, 2007
PEDIATRICS Vol. 119 No. 4 April 2007, pp. e866-e874 (doi:10.1542/peds.2006-1729)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Clements, K. M.
Right arrow Articles by Wilber, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Clements, K. M.
Right arrow Articles by Wilber, N.
Related Collections
Right arrow Premature & Newborn

ARTICLE

Preterm Birth–Associated Cost of Early Intervention Services: An Analysis by Gestational Age

Karen M. Clements, ScDa, Wanda D. Barfield, MD, MPHa, M. Femi Ayadi, PhDb and Nancy Wilber, EdDa

a Center for Community Health, Massachusetts Department of Public Health, Boston, Massachusetts
b Healthcare Administration Program, School of Business, University of Houston-Clear Lake, Houston, Texas

OBJECTIVES. Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth.

METHODS. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined.

RESULTS. Overall, 14033 of 76901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants.

CONCLUSIONS. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

Key Words: early intervention • gestational age • cost analysis • prematurity • educational intervention

Abbreviations: EI—early intervention • GA—gestational age • PELL—Pregnancy to Early Life Longitudinal

Accepted Oct 16, 2006.




This article has been cited by other articles:


Home page
 Arch Pediatr Adolesc MedHome page
S. R. Hintz, D. E. Kendrick, B. R. Vohr, W. K. Poole, R. D. Higgins, and for the National Institute of Child Health and Hum
Community Supports After Surviving Extremely Low-Birth-Weight, Extremely Preterm Birth: Special Outpatient Services in Early Childhood
Arch Pediatr Adolesc Med, August 1, 2008; 162(8): 748 - 755.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
I. A. Buhimschi, E. Zambrano, C. M. Pettker, M. O. Bahtiyar, M. Paidas, V. A. Rosenberg, S. Thung, C. M. Salafia, and C. S. Buhimschi
Using Proteomic Analysis of the Human Amniotic Fluid to Identify Histologic Chorioamnionitis
Obstet. Gynecol., February 1, 2008; 111(2): 403 - 412.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
R. Ruano, E. J. de A Pimenta, M. M. da Silva, J. G. Maksoud, and M. Zugaib
Percutaneous Intrauterine Laser Ablation of the Abnormal Vessel in Pulmonary Sequestration With Hydrops at 29 Weeks' Gestation
J. Ultrasound Med., September 1, 2007; 26(9): 1235 - 1241.
[Full Text] [PDF]