While previous studies demonstrated that developmentally supportive, family centered care reduces hospital charges, this systematic replication demonstrated that such care reduces hospital costs.
Individualized developmental support for very low birth weight infants was incorporated into ongoing caregiving through close consultation between a trained infant developmental specialist and each caregiver. Consultation was based on formal, serial observations of infants' responses to caregiving activities using the Newborn Individualized Developmental Care and Assessment Program (NIDCAP®). The costs of hospital care for fourteen (N=14) very low birthweight newborns were compared using a commercially available cost accounting system (Transition Systems, Inc. Boston, MA). Infants were concurrently enrolled and randomly assigned to either a NIDCAP® (n=8) or a control (n=6) group. The NIDCAP® infants received specialized care. The control infants received high quality, traditional care with access to all services.
The mean cost for NIDCAP® infants was $38,500 less than for control infants. The median cost was $52,000 less. The total mean savings for the developmentally supported group was $308,000. This cost advantage resulted from less intense use of therapies, particularly in the first three weeks after birth. Specialized nursing, laboratory, pharmacology, and radiology costs were less for the developmentally supported infants. Groups did not significantly differ in length of hospital stay.
Furthermore, this study replicated findings of earlier studies which demonstrated that developmentally supported infants had fewer days of mechanical ventilation as well as earlier onset of full enteral and full nipple feedings.
These results suggest that psychosocial care can produce significant cost savings and also improve patient outcomes in hospital settings.
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(Spon by: Fernando Moya, M.D.)
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Philbin, M., Ballweg, D., Tsakiri, S. et al. Hospital Cost Savings and Physiologic Benefit of Developmentally Supportive Care for Very Low Birth Weight Newborns 222. Pediatr Res 43 (Suppl 4), 40 (1998). https://doi.org/10.1203/00006450-199804001-00243
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DOI: https://doi.org/10.1203/00006450-199804001-00243
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