Our goal was to determine the contribution of GA and survival to total cost for the US newborn population, initial hospital costs were determined for inborn infants from 1989-92. Professional and hospital charges were collected on all non-survivors, survivors ≤ 32wks, and 300 randomly selected survivors >32wks (total n = 958). Using GA distribution of births and recent survival rates (published elsewhere), cost by GA and survival were extrapolated to 3.98 million US livebirths. Cost was related to GA and length of stay in survivors but only to length of stay in non-survivors (p < 0.05, log. regression). Cost per survivor decreased from $145,000 at 24wks to $441 at term; however,because more births occur at higher GA, total cost showed a bimodal distribution (figure). Total cost for the US population is $10.2 billion, with babies ≤ 29 and ≥ 37wks accounting for 27% and 43% of total cost respectively. The mathematical model developed from this data allows cost savings to be predicted for strategies altering outcome or GA. ACHPR #28292-92-0055

figure 1

Figure 1