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Outcomes and resource utilization for newborns with major congenital malformations: the initial NICU admission
J B Lindower1, H D Atherton, U R Kotagal
1Division of Neonatology, Children's Hospital Medical Center, Cincinnati, OH, USA.
Hypothesis:
Newborns with major congenital malformations (MCM) have contributed to a significant proportion of resource utilization in a regional referral neonatal intensive care unit (NICU).
Setting:
The Children's Hospital Medical Center NICU, Cincinnati, OH.
Subjects:
Newborns with and without MCM admitted from August 1, 1993 through July 31, 1994. Total patients studied were 572; 147 with and 385 without MCM. No intervention was performed in this observational study.
Statistics:
Statistics were t test, chi-squared, and rank sum analysis.
Results:
MCM accounted for 27.6% of NICU referrals, 32.4% of total NICU days, and 39.6% of NICU costs. Both median cost per patient and length of stay were significantly (p < 0.01) higher for patients with MCM than those without MCM. Surgery was more frequent in MCM than non-MCM cases. Thirty-three percent of the newborns with MCM received ongoing medical support at discharge.
Conclusion:
Patients with MCM remain as one of the largest and costliest groups hospitalized in a referral NICU.