Health-care spending and utilization for children discharged from a neonatal intensive care unit

Area of Science:

• Health Economics
• Pediatric Healthcare
• Neonatal Care

Background:

• Neonatal intensive care unit (NICU) graduates represent a vulnerable population with potentially high healthcare needs post-discharge.
• Understanding the long-term healthcare spending and utilization patterns for these infants is crucial for resource allocation and care planning.

Purpose of the Study:

• To describe the health-care spending and utilization patterns for infants discharged from the NICU up to their third birthday.
• To identify clinical characteristics associated with hospitalization and emergency department (ED) visits in NICU graduates.

Main Methods:

• Retrospective cohort analysis of 4973 NICU graduates using the Truven MarketScan Medicaid database.
• Follow-up extended to the infants' third birthday to assess healthcare spending and utilization.
• Logistic regression analysis was employed to determine factors associated with hospital and ED visits.

Main Results:

• The majority of post-NICU spending (69.5%) occurred within the first year, averaging $33,276 per member per year.
• Inpatient care constituted the largest portion (71.6%) of total 3-year healthcare expenditures.
• Readmission and ED visit rates within the first year were 36.8% and 63.7%, respectively.
• Medical technology use was significantly associated with higher likelihoods of hospitalizations (aOR 17.8) and ED visits (aOR 2.3).

Conclusions:

• Hospital care represents the predominant component of healthcare spending for NICU graduates.
• Infants dependent on medical technology exhibit an elevated risk for hospital admissions and emergency department utilization.