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Cost, causes and rates of rehospitalization of preterm infants

Journal of Perinatology volume 27, pages 614–619 (2007)Cite this article

Abstract

Objective:

To examine hospital readmissions for premature infants during the first year of life.

Study Design:

The California maternal and newborn/infant hospital discharge records were examined for subsequent readmission during the first year of life for all newborns from 1992 to 2000. Discharge diagnoses, hospital days, demographic data and hospital charges for infants born preterm (<36 weeks gestation) were identified and evaluated.

Result:

About 15% of preterm infants required at least one rehospitalization within the first year of life (average cost per readmission $8468, average annual cost in excess of $41 million). Infants with gestational age <25 weeks had the highest rate of readmission (31%) and longest average length of stay (12 hospital days). The largest cohort, infants born at 35 weeks gestation, had the highest total cost of readmission ($92.9 million). The most common cause of rehospitalization was acute respiratory disease. There was no decrease in the number or cost of readmissions of premature infants for respiratory syncytial virus infections following the introduction of palivizumab in 1998.

Conclusion:

After initial discharge, premature infants continue to have significant in-patient health-care needs and costs.

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References

  1. Lamarche-Vadel A, Blondel B, Truffert P, Burguet A, Cambonie G, Selton D et al. Re-hospitalization in infants younger than 29 weeks'gesatation in the EPIPAGE cohort. Acta Paediatr 2004; 93: 1340–1345.

    Article  CAS  Google Scholar 

  2. Petrou S, Sach T, Davidson L . The long term costs of preterm birth and low birth weight: results of a systematic review. Child Care Health Dev 2001; 27: 97–115.

    Article  CAS  Google Scholar 

  3. Schmitt SK, Sneed L, Phibbs CS . Costs of newborn care in California: a population-based study. Pediatrics 2006; 117: 154–160.

    Article  Google Scholar 

  4. Gilbert WM, Nesbitt TS, Danielsen B . The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol 2003; 102: 488–492.

    PubMed  Google Scholar 

  5. Petrou S . Economic consequences of preterm birth and low birth weight. BJOG 2003; 110 (Suppl 20): 17–23.

    Article  Google Scholar 

  6. Tommiska V, Tuomnien R, Fellman V . Economic costs of care in extremely low birthweight infants during the first two years of life. Pediatr Crit Care Med 2003; 4: 157–163.

    Article  Google Scholar 

  7. Petrou S, Mehta Z, Hockley C, Cook-Mozaffari P, Henderson J, Goldacre M . The impact of preterm birth on hospital inpatient admissions and costs during the first five years of life. Pediatrics 2003; 112: 1290–1297.

    Article  Google Scholar 

  8. Morris BH, Gard CC, Kennedy K . Rehospitalization of extremely low birth weight infants: are there racial/ethnic disparities? J Perinatol 2005; 25: 656–663.

    Article  Google Scholar 

  9. Phibbs CS, Schmitt SK . Estimates of the cost and length of stay changes that can be attributed to one-week increases in gestational age for premature infants. Early Hum Dev 2006; 82: 85–92.

    Article  Google Scholar 

  10. Williams RL, Creasy RK, Cunningham GC, Hawes WE, Norris FD, Tashiro M . Fetal growth and perinatal viability in California. Obstet Gynecol 1982; 59: 624–632.

    CAS  PubMed  Google Scholar 

  11. Wang ML, Dorer DJ, Fleming MP, Catlin EA . Clinical outcomes of near-term infants. Pediatrics 2004; 114: 372–376.

    Article  Google Scholar 

  12. Escobar GJ, Clark RH, Greene JD . Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol 2006; 30: 28–33.

    Article  Google Scholar 

  13. Elliott JP, Istwan NB, Jacques DL, Coleman SK, Stanziano GJ . Consequences of nonindicated preterm delivery in singleton gestations. J Reprod Med 2003; 48: 713–717.

    PubMed  Google Scholar 

  14. Morris JM, Roberts CL, Crowther CA, Buchanan SL, Henderson-Smart DJ, Salkeld G . Protocol for the immediate delivery versus expectant care of women with preterm prelabour rupture of the membranes close to term (PPROMT) Trial. BMC Pregnancy Childbirth 2006; 6: 9.

    Article  Google Scholar 

  15. Centers for Disease Control and Prevention, National Center for Infectious Diseases. Respiratory Syncytial Virus. 2004. Available at: www.cdc.gov/ncidod/aip/research/rsv.html.

  16. The IMpact-RSV Study Group. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 1998; 102: 531–537.

  17. American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Fetus and Newborn. Policy statement: prevention of respiratory syncytial virus infections: indications for the use of palivizumab and update on the use of RSV-IGIV (RE9839). Pediatrics 1998; 102: 1211–1216.

  18. Wegner S, Vann JJ, Liu G, Byrns P, Cypra C, Campbell W et al. Direct cost analyses of palivizumab treatment in a cohort of at-risk children: evidence from the North Carolina Medicaid Program. Pediatrics 2004; 104: 1612–1619.

    Article  Google Scholar 

  19. Vogel AM, Lennon DR, Broadbent R, Byrnes CA, Grimwood K, Mildenhall L et al. Palivizumab prophylaxis of respiratory syncytial virus in high-risk infants. J Paediatr Child Health 2002; 38: 550–554.

    Article  CAS  Google Scholar 

  20. Heikkinen T, Valkonen H, Lehtonen L, Vainionpaa R, Ruuskanen O . Hospital admission of high risk infants for respiratory syncytial virus infection: implications for palivizumab prophylaxis. Arch Dis Child Fetal Neonatal Ed 2005; 90: F64–F68.

    Article  CAS  Google Scholar 

  21. Suresh S, Schilling S, Dakin C, Harris MA . Palivizumab prophylaxis of respiratory syncytial virus infection in high-risk infants: a note of caution. J Paediatr Child Health 2003; 39: 637.

    Article  CAS  Google Scholar 

  22. Farina D, Rodriguez SP, Bauer G, Novali L, Bouzas L, Gonzalez H et al. Respiratory syncytial virus prophylaxis: cost-effective analysis in Argentina. Pediatr Infect Dis J 2002; 21: 287–291.

    Article  Google Scholar 

  23. Roeckl-Wiedmann I, Liese JG, Grill E, Fischer B, Carr D, Belohradsky BH . Economic evaluation of possible prevention of RSV-related hospitalizations in premature infants in Germany. Eur J Pediatr 2003; 162: 237–244.

    PubMed  Google Scholar 

  24. Elhassan NO, Sorbero ME, Hall CB, Stevens TP, Dick AW . Cost-effectiveness analysis of palivizumab in premature infants without chronic lung disease. Arch Pediatr Adolesc Med 2006; 160: 1070–1076.

    Article  Google Scholar 

  25. Yasmeen S, Romano PS, Schembri ME, Keyzer JM, Gilbert WM . Accuracy of obstetric diagnoses and procedures in hospital discharge data. Am J Obstet Gynecol 2006; 194: 992–1001.

    Article  Google Scholar 

  26. Romano PS, Yasmeen S, Schembri ME, Keyzer JM, Gilbert WM . Coding of perineal lacerations and other complications of obstetric care in hospital discharge data. Obstet Gynecol 2005; 106: 717–725.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pediatrics, University of California Davis School of Medicine, Davis, CA, USA

    M A Underwood

  2. Health and Information Solutions, Rocklin, CA, USA

    B Danielsen

  3. Women's Services, Sutter Health, Sacramento, CA, USA

    W M Gilbert

Authors
  1. M A Underwood
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  2. B Danielsen
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  3. W M Gilbert
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Correspondence to M A Underwood.

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The authors have indicated that they have no financial relationship relevant to this article to declare.

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Underwood, M., Danielsen, B. & Gilbert, W. Cost, causes and rates of rehospitalization of preterm infants. J Perinatol 27, 614–619 (2007). https://doi.org/10.1038/sj.jp.7211801

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