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The cost of intensive and special care of the newborn
P B Marshall1, H J Halls, S L James
1Flinders Medical Centre, Bedford Park, SA.
Insights
The cost of neonatal intensive care (level-3) and special care (level-2) for newborns was determined. Nursing staff represented the largest cost component for neonatal care services.
Area of Science:
- Neonatal medicine
- Health economics
- Perinatal care
Background:
- Tertiary perinatal services provide critical care for newborns.
- Understanding the cost of neonatal care is essential for resource allocation.
- Previous cost analyses may not reflect current intensive and special care needs.
Purpose of the Study:
- To prospectively determine the costs of intensive (level-3) and special (level-2) neonatal care.
- To identify the major cost components in providing these levels of newborn care.
- To establish cost benchmarks in 1984 Australian dollars.
Main Methods:
- Prospective cost determination per occupied bed-day.
- Categorization of costs into level-3 (high/low dependency) and level-2 (high/low dependency) care.
- Inclusion of direct and additional daily costs.
Main Results:
- Over-all level-3 care cost $544/bed-day; level-2 care cost $201/bed-day.
- With additional costs, the combined average cost was $339/bed-day.
- Nursing staff (50%), consumables (12%), and diagnostics (8%) were major cost drivers.
Conclusions:
- Neonatal intensive and special care services incur significant costs.
- Nursing staff salaries are the primary driver of neonatal care expenses.
- Accurate cost data is vital for efficient management of perinatal services.
Abstract:
The cost of providing intensive (level-3) and special (level-2) care for newborn infants in a tertiary perinatal service was determined prospectively and was expressed in 1984 Australian dollars. Direct costs that were expressed per occupied bed-day were $690 for level-3, high-dependency care; $421 for level-3, low-dependency care; $544 for over-all level-3 care; $242 for level-2, high-dependency care; $170 for level-2, low-dependency care; and $201 for over-all level-2 care. Each level of care generated additional costs of $42 per occupied bed-day. Taking these additional costs into account, the over-all occupied bed-day cost of level-3 and level-2 neonatal care was $339. The major components of this over-all cost were: nursing staff members, 50%; medical staff members, 11%; consumable and recyclable items, 12%; and diagnostic services, 8%.