229250 Neonatal Intensive Care Unit Costs of Morbidities in Very Low Birthweight Infants

Wednesday, November 10, 2010

Tricia Johnson, PhD , Department of Health Systems Management, Rush University/Rush University Medical Center, Chicago, IL
Briana Jegier, PhD , Women, Children and Family Nursing, Rush University, Chicago, IL
Janet Engstrom, PhD , Women, Children and Family Nursing, Rush University, Chicago, IL
Paula Meier, PhD , Women, Children and Family Nursing, Rush University, Chicago, IL
OBJECTIVES: Very low birthweight (VLBW; <1500 g birthweight) infants are among the most expensive hospitalized patients, primarily because they are at high risk for multiple morbidities that translate into longer hospital stays, generally in the neonatal intensive care unit. The purpose of this study was to determine the hospital cost, charges and payments for morbidities experienced by VLBW infants during their initial hospitalization.

METHODS: This retrospective, cross-sectional analysis examined all VLBW infants discharged between July 1, 2005 and June 30, 2009 at an academic medical center. Mean hospital costs, charges and payments were analyzed across individual morbidities and the most common combinations of morbidities, including necrotizing entercolitis (NEC), sepsis, retinopathy of prematurity (ROP), chronic lung disease (CLD) and respiratory distress syndrome (RDS).

RESULTS: Of the 587 premature, VLBW infants, 72.2% were diagnosed with RDS, 59.6% with ROP, 44.8% with CLD, 32.4% with sepsis and 7.3% with NEC. The most common combinations of morbidities were RDS, ROP and CLD (20.6%); sepsis, RDS, ROP and CLD (12.4%) and RDS only (9.5%),while 18.2% had none of the five morbidities. The average hospital costs and payments ranged from $29,453 (costs) and $67,043 (payments) for infants with RDS to $127,240 and $269,691, respectively, for infants with all five morbidities.

CONCLUSIONS: These findings indicate that VLBW infants who experience more morbidities have substantially higher costs than those without morbidities. Average costs for individual morbidities provide an incomplete picture of the costs associated with VLBW infants. The combination of morbidities is important drivers of costs.

Learning Areas:
Biostatistics, economics
Provision of health care to the public
Public health or related research

Learning Objectives:
1. To identify the most common morbidities and combinations of morbidities in very low birthweight (VLBW) infants 2. To understand differences in hospital costs and payments for the neonatal intensive care unit (NICU) across the most common combinations of morbidities in VLBW infants.

Keywords: Infant Health, Cost Issues

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversee the design and analysis of the study
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Medela, Inc. N/A Consultant

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.