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.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
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.
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.
Schmitt SK, Sneed L, Phibbs CS . Costs of newborn care in California: a population-based study. Pediatrics 2006; 117: 154–160.
Gilbert WM, Nesbitt TS, Danielsen B . The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol 2003; 102: 488–492.
Petrou S . Economic consequences of preterm birth and low birth weight. BJOG 2003; 110 (Suppl 20): 17–23.
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.
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.
Morris BH, Gard CC, Kennedy K . Rehospitalization of extremely low birth weight infants: are there racial/ethnic disparities? J Perinatol 2005; 25: 656–663.
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.
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.
Wang ML, Dorer DJ, Fleming MP, Catlin EA . Clinical outcomes of near-term infants. Pediatrics 2004; 114: 372–376.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Author information
Authors and Affiliations
Corresponding author
Additional information
Conflict of interest
The authors have indicated that they have no financial relationship relevant to this article to declare.
Rights and permissions
About this article
Cite this article
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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jp.7211801
Keywords
This article is cited by
-
Risk factors associated with 31-day unplanned hospital readmission in newborns: a systematic review
European Journal of Pediatrics (2023)
-
Risk factors for death during newborn and post-newborn hospitalizations among preterm infants
Journal of Perinatology (2022)
-
The amniotic fluid proteome predicts imminent preterm delivery in asymptomatic women with a short cervix
Scientific Reports (2022)
-
Healthcare Prometrics in the Era of Redeployment
Journal of the Knowledge Economy (2022)
-
The association of care transitions measure-15 score and outcomes after discharge from the NICU
BMC Pediatrics (2021)