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Health-care spending and utilization for children discharged from a neonatal intensive care unit

Journal of Perinatology volume 38, pages 734–741 (2018)Cite this article

Subjects

Abstract

Objectives

To describe health-care spending and utilization for infants discharged from the neonatal intensive care unit (NICU).

Study design

Retrospective cohort analysis of 4973 NICU graduates in the Truven MarketScan Medicaid database, with follow-up to the third birthday. Health-care spending and utilization after NICU discharge were assessed. Using logistic regression, we assessed clinical characteristics associated with hospitalization and emergency department (ED) visits.

Results

Most (69.5%) post-NICU spending occurred within the first year [$33,276 per member per year]. Inpatient care accounted for most (71.6%) of the 3-year spending. The percentages of infants with a 1-year readmission or ED visit were 36.8% and 63.7%, respectively. Medical technology was associated with the highest likelihoods of hospital [aOR 17.8 (95%CI 12.2–26.0)] and ED use [aOR 2.3 (95%CI 1.8–3.0)].

Conclusions

Hospital care accounts for the majority of spending for NICU graduates. Infants with medical technology have the highest risk of hospital and ED use.

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Acknowledgements

DZK and CJS were supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number R40MC23626. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University at Buffalo, Buffalo, NY, USA

    Dennis Z. Kuo

  2. Complex Care Service, Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Jay G. Berry

  3. Children’s Hospital Association, Lenexa, KS, USA

    Matt Hall

  4. Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Robert E. Lyle

  5. Arkansas Children’s Research Institute, Little Rock, AR, USA

    Robert E. Lyle

  6. Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA

    Christopher J. Stille

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  1. Dennis Z. Kuo
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Correspondence to Dennis Z. Kuo.

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Kuo, D.Z., Berry, J.G., Hall, M. et al. Health-care spending and utilization for children discharged from a neonatal intensive care unit. J Perinatol 38, 734–741 (2018). https://doi.org/10.1038/s41372-018-0055-5

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