A treatment program for failure to thrive: a cost/effectiveness analysis

Failure to thrive (FTT) is a frequent cause for the admission of infants to the hospital. Such hospitalizations are often lengthy and expensive, and usually do not contribute to an understanding of the etiology of FTT. Generally, organic causes of FTT can be ruled out by a thorough history and physical examination. In this study two groups were examined: 17 infants who were admitted to foster medical placement homes (MPH), private homes with specially trained parents; and a comparison group of 18 infants who were treated in a more traditional way with diagnostic hospitalization. The groups were similar in all regards prior to admission. All infants were less than a year of age. Family disruption was a prominent feature in both groups, but socio-demographic analysis showed them to be similar in all areas studied. The comparison group gained an average of 276 grams in the hospital over 8.6 days. The MPH group gained 362 grams in the hospital over 8.7 days, with an additional 1270 grams in the medical placement home over 31.1 days. Five children were admitted to the medical placement home without hospitalization. After correcting for an expected weight gain of 15 grams per day (normal growth), the comparison group showed a catch-up growth of 16 gms/day, while the MPH group gained 29 gms/day in excess of expectation, almost twice the comparison group. A 100-gram weight gain cost +308 in the MPH program and +1,635 in the traditional approach. This five-fold difference was felt to be a significant deterrent to the continuing approach of admitting children to the hospital for for the workup of FTT.(ABSTRACT TRUNCATED AT 250 WORDS)