Published online July 2, 2007
PEDIATRICS Vol. 120 No. 1 July 2007, pp. e1-e9 (doi:10.1542/peds.2006-2386)
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 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 Russell, R. B.
Right arrow Articles by Petrini, J. R.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Russell, R. B.
Right arrow Articles by Petrini, J. R.
Related Collections
Right arrow Premature & Newborn

ARTICLE

Cost of Hospitalization for Preterm and Low Birth Weight Infants in the United States

Rebecca B. Russell, MSPHa, Nancy S. Green, MDa,b,c, Claudia A. Steiner, MD, MPHd, Susan Meikle, MD, MSPHd, Jennifer L. Howse, PhDa, Karalee Poschman, MPHa, Todd Dias, MSa, Lisa Potetz, MPPa, Michael J. Davidoff, MPHa, Karla Damus, PhD, RNa,c and Joann R. Petrini, PhD, MPHa,c

a March of Dimes, White Plains, New York
b Departments of Pediatrics
c Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York
d Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland

OBJECTIVE. The objective of this study was to estimate national hospital costs for infant admissions that are associated with preterm birth/low birth weight.

METHODS. Infant (<1 year) hospital discharge data, including delivery, transfers, and readmissions, were analyzed by using the 2001 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project. The Nationwide Inpatient Sample is a 20% sample of US hospitals weighted to approximately >35 million hospital discharges nationwide. Hospital costs, based on weighted cost-to-charge ratios, and lengths of stay were calculated for preterm/low birth weight infants, uncomplicated newborns, and all other infant hospitalizations and assessed by degree of prematurity, major complications, and expected payer.

RESULTS. In 2001, 8% (384200) of all 4.6 million infant stays nationwide included a diagnosis of preterm birth/low birth weight. Costs for these preterm/low birth weight admissions totaled $5.8 billion, representing 47% of the costs for all infant hospitalizations and 27% for all pediatric stays. Preterm/low birth weight infant stays averaged $15100, with a mean length of stay of 12.9 days versus $600 and 1.9 days for uncomplicated newborns. Costs were highest for extremely preterm infants (<28 weeks’ gestation/birth weight <1000 g), averaging $65600, and for specific respiratory-related complications. However, two thirds of total hospitalization costs for preterm birth/low birth weight were for the substantial number of infants who were not extremely preterm. Of all preterm/low birth weight infant stays, 50% identified private/commercial insurance as the expected payer, and 42% designated Medicaid.

CONCLUSIONS. Costs per infant hospitalization were highest for extremely preterm infants, although the larger number of moderately preterm/low birth weight infants contributed more to the overall costs. Preterm/low birth weight infants in the United States account for half of infant hospitalization costs and one quarter of pediatric costs, suggesting that major infant and pediatric cost savings could be realized by preventing preterm birth.

Key Words: prematurity • newborns • infants • hospital costs • low birth weight • morbidities

Abbreviations: LBW—low birth weight • LOS—length of stay • NIS—Nationwide Inpatient Sample • HCUP—Healthcare Cost and Utilization Project • ICD-9-CM—International Classification of Diseases, Ninth Revision, Clinical Modification • C/C—cost-to-charge ratio • RDS—respiratory distress syndrome • BPD—bronchopulmonary dysplasia • IVH—intraventricular hemorrhage • NEC—necrotizing enterocolitis

Accepted Jan 25, 2007.




This article has been cited by other articles:


Home page
 Proc Am Thorac SocHome page
N. W. Johnston
The Similarities and Differences of Epidemic Cycles of Chronic Obstructive Pulmonary Disease and Asthma Exacerbations
Proceedings of the ATS, December 1, 2007; 4(8): 591 - 596.
[Abstract] [Full Text] [PDF]

Home page
 Policy Politics Nursing PracticeHome page
K. G. Balk
Recommended Newborn Screening Policy Change for the NICU Infant
Policy Politics Nursing Practice, August 1, 2007; 8(3): 210 - 219.
[Abstract] [PDF]