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Cost-effectiveness analysis of Malaysian neonatal intensive care units
Irene Guat Sim Cheah1, Anna Padma Soosai, Swee Lan Wong
1Department of Paediatrics, Paediatric Institute, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
Insights
Neonatal intensive care for infants weighing 1000-1500g is cost-effective, with a 78% survival rate to one year. This analysis provides valuable data for public health services.
Area of Science:
- Neonatal Medicine
- Health Economics
- Public Health
Background:
- Infants between 1000 and 1500 g birthweight represent a critical group requiring specialized neonatal intensive care.
- Assessing the cost-effectiveness of neonatal intensive care is crucial for resource allocation in public health systems.
Purpose of the Study:
- To conduct a cost-effective analysis of neonatal intensive care for infants weighing 1000-1500 g.
- To evaluate survival outcomes at one year of age for this specific birthweight cohort.
Main Methods:
- A multicenter observational study involving 333 infants.
- Data collected on outcomes (survival to 1 year), costs, and cost-effectiveness ratios.
- Analysis of neonatal intensive care provided by Ministry of Health (MOH) Pediatric services.
Main Results:
- Overall survival probability at 1 year was 78%.
- Survival rates varied by birth weight and gestational age (e.g., 77% for 1000-1249g, 80% for 28-36 weeks gestation).
- The average cost-effectiveness ratio was US$3979 per survivor at 1 year.
Conclusions:
- Neonatal intensive care services for the study group were found to be cost-effective when compared to developed countries.
- Variability in outcomes and cost-effectiveness across different neonatal units warrants further investigation.
Objective:
To perform a cost-effective analysis on the care of infants between 1000 and 1500 g birthweight (the study group), where outcomes are measured as survival to 1 year of age.
Methodology:
This was a multicenter observational study to determine the outcome, cost and cost-effectiveness of neonatal intensive care provided by Ministry of Health (MOH) Pediatric services. A total of 333 patients enrolled were eligible for analysis according to the inclusion and exclusion criteria of this study.
Results:
Overall survival probability of the study group infants at 1 year of age was 78%. Survival at 1-year of age was 77% for infants with birth weight 1000 to 1249 g, 79% for 1250 to 1499 g. Survival at 1 year of age for the sample group was 53% for 22 to 27 weeks gestation, 80% for 28 to 36 weeks. The average cost-effectiveness ratio (CER) of neonatal intensive care for the study group infants was US$3979 [corrected] per survivor at 1 year of age (95% confidence interval US$3411, 5160).
Conclusion:
There was variability in the outcome and cost-effectiveness between the neonatal units, which need to be further assessed. However, neonatal intensive care services provided for the study group infants were cost-effective compared to that in developed countries.
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