PEDIATRICS Vol. 81 No. 3 March 1988, pp. 372-378
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Medical Care Costs of High-Risk Infants After Neonatal Intensive Care: A Controlled Study

Seetha Shankaran MD1, Sanford N. Cohen MD1, Marsha Linver MA1, and Susan Zonia PhD1

1 From the Department of Pediatrics and Developmental Disabilities Institute, Wayne State University School of Medicine and Children's Hospital of Michigan, Detroit

Total medical care costs were studied prospectively from neonatal intensive care unit (NICU) discharge to 3 years of age for 60 children, 35 of whom had neurologic and/or developmental deficits detected immediately following NICU discharge and 25 children did not. At the end of the study period the children were classified as unhandicapped (group A), mildly handicapped (group B), or moderately-severely handicapped (group C). Medical costs are reported per infant per month following NICU discharge (mean ± SD). The outpatient costs in group A were $31 ± 23 as compared with $86 ± 93 in group B and $109 ± 59 in group C (A < B, A < C; P < .001). The greatest contributor to outpatient costs was occupational and physical therapy (with unproven efficiency to date). The inpatient costs were $31 ± 56 in group A, $328 ± 574 in group B, and $542 ± 737 in group C (A < C; P < .01). The US Department of Agriculture estimates of medical costs of raising a child at home ranges from $22 to $26.80 per month. The cost of raising one of our NICU infants in an institution was $1,216 per month. Children with and without neurodevelopmental deficits after NICU discharge have significantly higher medical costs than children without.

Key Words: medical care costs • high-risk infant

Submitted on December 12, 1986
Accepted on May 27, 1987




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