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Study comparing "Kangaroo Ward Care" with "Intermediate Intensive Care" for improving the growth outcome and cost
Deepak Sharma1, Srinivas Murki1, Tejo Pratap Oleti1
1a Department of Neonatology , Fernandez Hospital , Hyderabad , India.
Insights
Kangaroo ward care (KWC) improves growth and is more cost-effective than intermediate intensive care (IIC) for low birth weight infants. Early transfer to KWC reduces hospital stay and healthcare costs for families.
Area of Science:
- Neonatal care
- Pediatric growth studies
- Health economics
Background:
- Stable infants with birth weights between 1000g and 1100g require specialized care.
- Comparing Kangaroo ward care (KWC) with Intermediate Intensive Care (IIC) is crucial for optimizing outcomes.
- Previous studies highlight the benefits of KWC for preterm infants.
Purpose of the Study:
- To compare the growth outcomes of infants receiving KWC versus IIC.
- To evaluate the cost-effectiveness of KWC compared to IIC.
- To determine the optimal timing for transferring infants to KWC.
Main Methods:
- A secondary analysis included 79 infants (1000g to <1100g birth weight).
- Infants were randomized to KWC (n=38) or IIC (n=41) at 1150g.
- KWC infants transferred immediately; IIC infants transferred at 1250g.
Main Results:
- KWC group showed significantly better weight and length gain post-randomization.
- KWC reduced hospital stay by 2 days and earlier transfer by 6 days.
- KWC resulted in significant cost savings of $570 per patient.
Conclusions:
- Early transfer to KWC for infants (1000g to <1100g) promotes better growth.
- Kangaroo ward care is a cost-effective strategy for this infant population.
- This approach optimizes resource utilization in neonatal care.
Aims:
The aim of this study was to compare growth outcome and cost effectiveness of "Kangaroo ward care" (KWC) with "Intermediate intensive care" (IIC) in stable infants with birth weight 1000 g to <1100 g.
Material And Methods:
In this secondary analysis, we included 79 infants, with birth weight 1000 g to <1100 g. Thirty-eight were randomized to KWC and 41 to IIC group once the infant reached a weight of 1150 g. Infants in the KWC group were shifted to Kangaroo ward immediately after randomization and in the IIC group received IIC care till they attained a weight of 1250 g before shifting to Kangaroo Ward. After shifting to Kangaroo ward, infants in the IIC group received equivalent care to KWC group infants.
Results:
There was significant better weight gain post-randomization during hospital stay and better length gain till 40 weeks of gestational age in intervention arm. There was reduction of post-randomization hospital stay by 2 d in the KWC group. The infants in the KWC group were shifted 6 d earlier to Kangaroo ward from IIC when compared with the IIC group. The cost-effective analysis that used "top-down" and "bottom-up" accounting method showed significant reduction of hospital and parents expenditure in the KWC group (p < .001) with saving of 570 USD per patient in the KWC group.
Conclusion:
Early shifting of infants to Kangaroo ward with birth weight 1000 g to <1100 g leads to better growth and is cost effective (CTRI/2014/05/004625).
Clinical Trial Registration:
Clinical trial registry of India CTRI/2014/05/004625.
