Published online June 29, 2009
PEDIATRICS Vol. 124 No. 1 July 2009, pp. 128-134 (doi:10.1542/peds.2008-1378)

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ARTICLE

Morbidities and Hospital Resource Use During the First 3 Years of Life Among Very Preterm Infants

Emmi Korvenranta, MD, MSc^a, Liisa Lehtonen, MD, PhD^a, Mikko Peltola, MSc^b, Unto Häkkinen, PhD^b, Sture Andersson, MD, PhD^c, Mika Gissler, PhD^d, Mikko Hallman, MD, PhD^e, Jaana Leipälä, MD, PhD^b, Liisi Rautava, MD^a, Outi Tammela, MD, PhD^f and Miika Linna, PhD^b

^a Department of Pediatrics, Turku University Hospital, Turku, Finland
^b Centre for Health Economics and
^d Information Unit, National Research and Development Centre for Welfare and Health, Helsinki, Finland
^c Department of Pediatrics, Hospital for Children and Adolescents, Helsinki, Finland
^e Department of Pediatrics, Oulu University Hospital, Oulu, Finland
^f Department of Pediatrics, Tampere University Hospital, Tampere, Finland

OBJECTIVE: The objective of this study was to determine how the use of hospital resources during the first 3 years of life was associated with prematurity-related morbidity in very preterm infants (gestational age of <32 weeks or birth weight of <1501 g).

METHODS: The study was a retrospective, national register study including all very preterm infants born alive in Finland between 2000 and 2003 (N = 2148). Infants who died before the age of 3 years (n = 264) or who had missing register data (n = 88) were excluded from the study. The relationship between 6 morbidity groups and the need for hospital care during the first 3 years of life was studied by using a negative binomial model.

RESULTS: A total of 66.2% of the infants did not have any of the morbidities studied. Infants who were subsequently diagnosed as having cerebral palsy (6.1% of the study group), later obstructive airway disease (20.0%), hearing loss (2.5%), visual disturbances or blindness (3.8%), or other ophthalmologic problems (13.4%) had initial hospital stays that were a mean of 7, 8, 12, 17, and 3 days longer, respectively, than those for infants without these conditions. All morbidity groups were associated with increased numbers of hospital visits during either the second or third year of life, compared with infants without these morbidities. The need for hospitalizations and outpatient hospital care decreased with postnatal age for infants with later morbidities and for infants without later morbidities.

CONCLUSIONS: Most very preterm infants born in Finland survived without severe morbidities and required relatively little hospital care after the initial discharge. However, those with later morbidities had a long initial length of stay and more readmissions and outpatient visits during the 3-year follow-up period.

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Key Words: chronic illness • health care use • length of stay • rehospitalization • very low birth weight

Abbreviations: CP—cerebral palsy • LOS—length of stay • SGA—small for gestational age • ICD-10—International Classification of Diseases • 10th Revision

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Accepted Nov 14, 2008.

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