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Cost of clinician-driven tests and treatments in very low birth weight and/or very preterm infants

Journal of Perinatology volume 41, pages 295–304 (2021)Cite this article

Subjects

Abstract

Objective

To rank clinician-driven tests and treatments (CTTs) by their total cost during the birth hospitalization for preterm infants.

Study design

Retrospective cohort of very low birth weight (<1500 g) and/or very preterm (<32 weeks) subjects admitted to US children’s hospital Neonatal Intensive Care Units (2012–2018). CTTs were defined as pharmaceutical, laboratory and imaging services and ranked by total cost.

Results

24,099 infants from 51 hospitals were included. Parenteral nutrition ($85M, 32% of pharmacy costs), blood gas analysis ($34M, 29% of laboratory costs), and chest radiographs ($18M, 31% of imaging costs) were the costliest CTTs overall. More than half of CTT-related costs occurred during 10% of hospital days.

Conclusions

The majority of CTT-related costs were from commonly used tests and treatments. Targeted efforts to improve value in neonatal care may benefit most from focusing on reducing unnecessary utilization of common tests and treatments, rather than infrequently used ones.

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Author information

Authors and Affiliations

  1. Section of Neonatology, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Brian C. King & Kanekal S. Gautham

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

    Troy Richardson & Matthew Hall

  3. Division of Neonatology, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Ravi M. Patel

  4. Division of Neonatology, Stanford University, Stanford, CA, USA

    Henry C. Lee

  5. Divison of Neonatology, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Nicolas A. Bamat

  6. Vanderbilt Center for Child Health Policy, Departments of Pediatrics and Health Policy, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN, USA

    Stephen W. Patrick

  7. Divison of Neonatology, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA

    Jonathan L. Slaughter

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  1. Brian C. King
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  8. Matthew Hall
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  9. Jonathan L. Slaughter
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Contributions

Conceptualization/design/methodology and Manuscript editing: BCK, TR, MH, NAB, HCL, KSG, JLS, RMP, SWP. Investigation/formal analysis and Manuscript drafting: BCK, TR, JLS. All authors gave final approval of the version to be published. All authors agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Brian C. King.

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The authors declare that they have no conflict of interest.

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King, B.C., Richardson, T., Patel, R.M. et al. Cost of clinician-driven tests and treatments in very low birth weight and/or very preterm infants. J Perinatol 41, 295–304 (2021). https://doi.org/10.1038/s41372-020-00879-6

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  • DOI: https://doi.org/10.1038/s41372-020-00879-6

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