Abstract
Objective: Very low birthweight (VLBW; < 1500g weight) infants often have multiple morbidities, translating into longer neonatal intensive care unit stays and higher hospital costs. The primary aim was to examine the relationship between morbidities and the charges, payments and costs for VLBW infants during their initial hospital stay.
Methods: This was a retrospective, cross-sectional analysis of all VLBW infants discharged alive between July 2005 and June 2009 at a large, urban academic medical center. Infants were classified by the presence of individual and combinations of morbidities, including necrotizing entercolitis (NEC), sepsis, retinopathy of prematurity (ROP), chronic lung disease (CLD) and respiratory distress syndrome (RDS). Mean hospital charges, payments and costs were examined across morbidities for infants < 750g and 750-1499g. Results: Of the 475 VLBW infants, 20.4% were < 750g at birth. The most expensive combinations of morbidities for infants < 750g were NEC, with or without other morbidities ($755,000 (2009 USD) charges; $312,700 payments; $161,500 costs) and the combination of sepsis, ROP, RDS and CLD ($715,800 charges; $291,900 payments; $159,300 costs). For infants 750-1499g, the most expensive combinations were sepsis, ROP, RDS and CLD ($438,300 charges; $195,900 payments; $99,100 costs), followed by ROP, RDS and CLD ($385,300 charges; $192,700 payments; $88,000 costs), while those without any morbidities were the least expensive ($119,000 charges; $66,900 payments; $29,800 costs).
Conclusions: It is critical to examine the combinations of morbidities, rather than simply the presence or absence of individual morbidities, to understand their effect on hospital charges, payments and costs.
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Johnson, T., Jegier, B., Engstrom, J. et al. 460 Neonatal Intensive Care Unit Costs of Morbidities in Very Low Birthweight Infants. Pediatr Res 68 (Suppl 1), 236 (2010). https://doi.org/10.1203/00006450-201011001-00460
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DOI: https://doi.org/10.1203/00006450-201011001-00460