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The economic consequences of preterm birth during the first 10 years of life
1National Perinatal Epidemiology Unit (NPEU), University of Oxford (Old Road Campus), Old Road, Headington, Oxford OX3 7LF, England, UK.
Insights
Preterm birth significantly increases long-term hospital costs and service use in children. Extremely preterm infants (<28 weeks) incur substantially higher healthcare expenses over their first decade.
Area of Science:
- Healthcare Economics
- Neonatal Research
- Public Health
Background:
- Preterm birth is a major global health concern with potential long-term implications.
- Understanding the economic burden associated with preterm birth is crucial for healthcare planning.
Purpose of the Study:
- To investigate the relationship between gestational age at birth and the long-term utilization and costs of hospital inpatient services.
- To quantify the economic impact of preterm birth on healthcare systems over the first 10 years of a child's life.
Main Methods:
- Utilized multi-level modeling to analyze hospital service utilization and costs.
- Included 117,212 children born between 1978-1988 in Oxfordshire and West Berkshire.
- Categorized children into four gestational age groups: <28, 28-31, 32-36, and ≥37 weeks.
Main Results:
- Children born extremely preterm (<28 weeks) had 130% more admissions, 77% more inpatient days, and 443% higher costs over 10 years compared to term infants.
- The cumulative cost for children born <28 weeks was £22,322.87, significantly higher than for those born at term (£3,409.14).
- Gestational age was strongly associated with increased hospital service utilization and associated costs throughout the first decade of life.
Conclusions:
- Preterm birth, particularly extreme preterm birth, results in substantial and prolonged economic consequences for healthcare services.
- The findings highlight the need for targeted interventions and resource allocation to mitigate the long-term economic burden of preterm birth.
- Adverse outcomes of preterm birth have significant societal and economic ramifications.
Objective:
To examine the association between gestational age at the time of birth and long-term use and cost of hospital inpatient services.
Design:
Multi-level modelling of the hospital service utilisation and cost profile of each child born in hospital during 1978-1988 in two areas covered by the Oxford Record Linkage Study.
Setting:
Oxfordshire and West Berkshire.
Population:
117,212 children divided into four subgroups by gestational age at birth: <28 weeks, 28-31 weeks, 32-36 weeks, 37 weeks or greater.
Main Outcome Measures:
Number and duration of hospital admissions during the first 10 years of life. Costs, expressed in pound sterling and valued at 1998-1999 prices, of hospital inpatient services.
Results:
The cumulative cost of hospital inpatient admissions incurred during the first 10 years of life, including the initial birth admission, averaged 17,819.94 [22,322.87 UK pounds] for children born at <28 weeks gestation, 17,751.00 [19,055.53 UK pounds] for children born at 28-31 weeks gestation, 5,376.39 [7,393.78 UK pounds] for children born at 32-36 weeks gestation, and 1,658.63 [3,409.14 UK pounds] for children born at 37 weeks gestation or greater. The adjusted number of hospital inpatient admissions, inpatient days and costs, respectively, over the first 10 years of life was 130%, 77% and 443% higher for children born at <28 weeks gestation than for children born at term.
Conclusion:
The adverse sequelae of preterm birth are likely to have considerable long-term economic consequences for the health services and for society as a whole.
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