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Cost-analysis of neonatal intensive and special care
D I Tudehope1, W Lee, F Harris
1Department of Neonatology, Mater Mothers' Hospital, South Brisbane, Queensland, Australia.
Insights
Neonatal intensive care costs vary significantly by birthweight, with extremely low birthweight infants incurring the highest expenses. This study provides a cost analysis for neonatal intensive care programs, essential for economic justification.
Area of Science:
- Neonatal Medicine
- Health Economics
- Healthcare Management
Background:
- Increasing expenditure on neonatal intensive care necessitates economic evaluation.
- There is a growing demand for justification of neonatal intensive care programs.
Purpose of the Study:
- To assess the in-hospital costs of neonatal intensive care.
- To provide economic justification for neonatal intensive care programs.
Main Methods:
- Calculated fixed and variable costs for Intensive/Special Care Nursery services in 1985.
- Corrected costs to 1987 Australian dollar equivalents.
- Estimated costs for establishing and operating a new 43-bed unit.
Main Results:
- Daily costs per baby: $1282 (ventilator), $481 (intensive), $293 (transitional), $287 (recovery).
- Cost per survivor inversely related to birthweight: $2400 (>2500g) to $63,450 (<1000g) in 1985.
- Costs for extremely low birthweight infants (1986-87): $128,400 (<800g) and $43,950 (800-999g).
Conclusions:
- Neonatal intensive care costs are substantial and vary significantly with birthweight.
- The methodology can serve as a basis for future cost-evaluation exercises.
- Economic justification for neonatal intensive care programs is crucial in the current climate.
Abstract:
In the present economic climate and with increasing expenditure on neonatal intensive care, there has been a demand for economic evaluation and justification of neonatal intensive care programmes. This study assesses the inhospital costs of neonatal intensive care. Fixed and variable costs were calculated for services and uses of an Intensive/Special Care Nursery for the year 1985 and corrected to 1987 Australian dollar equivalents. Establishing a new neonatal intensive care unit of 43 costs in an existing hospital with available floor space including operating costs for a year were estimated in Australian dollars for 1987 at $6,408,000. Daily costs per baby for each were $1282 ventilator, $481 intensive, $293 transitional and $287 recovery, respectively. The cost per survivor managed in the Intensive/Special Care Nursery in 1985 showed the expected inverse relationship to birthweight being $2400 for greater than 2500 g, $4050 for 2000-2500 g, $9200 for 1500-1999 g, $23,900 for 1000-1499 g and $63,450 for less than 1000 g. Further analysis for extremely low birthweight infants managed in 1986 and 1987 demonstrated costs per survivor of $128,400 for infants less than 800 g birthweight and $43,950 for those 800-999 g. This methodology might serve as a basis for further accounting and cost-evaluation exercises.