Related Experiment Videos
Medical care costs of high-risk infants after neonatal intensive care: a controlled study
S Shankaran1, S N Cohen, M Linver
1Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI.
Insights
Children with neurodevelopmental deficits after neonatal intensive care unit (NICU) discharge incur significantly higher medical costs. These costs, including therapy and institutional care, far exceed those for typically developing children.
Area of Science:
- Pediatrics
- Health Economics
- Developmental Pediatrics
Background:
- Neonatal intensive care unit (NICU) graduates are at risk for neurodevelopmental deficits.
- Long-term medical costs for these children are not fully understood.
Purpose of the Study:
- To prospectively analyze total medical care costs from NICU discharge to 3 years of age.
- To compare costs between children with and without neurodevelopmental deficits.
Main Methods:
- Prospective study of 60 children from NICU discharge to age 3.
- Children categorized into unhandicapped, mildly handicapped, and moderately-severely handicapped groups.
- Medical costs (outpatient and inpatient) tracked and reported per infant per month.
Main Results:
- Outpatient costs were significantly higher for handicapped groups (Group B: $86±$93, Group C: $109±$59) compared to unhandicapped (Group A: $31±$23; P<.001).
- Inpatient costs were substantially higher for handicapped groups (Group B: $328±$574, Group C: $542±$737) versus unhandicapped (Group A: $31±$56; P<.01).
- Occupational and physical therapy were major outpatient cost drivers.
Conclusions:
- Children with neurodevelopmental deficits post-NICU discharge incur significantly greater medical costs.
- Institutional care for NICU graduates was substantially more expensive ($1,216/month) than estimated home care costs.
- Early identification and management of neurodevelopmental deficits are crucial for cost-effective care planning.
Abstract:
Total medical care costs were studied prospectively from neonatal intensive care unit (NICU) discharge to 3 years of age for 60 children, 35 of whom had neurologic and/or developmental deficits detected immediately following NICU discharge and 25 children did not. At the end of the study period the children were classified as unhandicapped (group A), mildly handicapped (group B), or moderately-severely handicapped (group C). Medical costs are reported per infant per month following NICU discharge (mean +/- SD). The outpatient costs in group A were $31 +/- 23 as compared with $86 +/- 93 in group B and $109 +/- 59 in group C (A less than B, A less than C; P less than .001). The greatest contributor to outpatient costs was occupational and physical therapy (with unproven efficiency to date). The inpatient costs were $31 +/- 56 in group A, $328 +/- 574 in group B, and $542 +/- 737 in group C (A less than C; P less than .01). The US Department of Agriculture estimates of medical costs of raising a child at home ranges from $22 to $26.80 per month. The cost of raising one of our NICU infants in an institution was $1,216 per month. Children with and without neurodevelopmental deficits after NICU discharge have significantly higher medical costs than children without.