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A treatment program for failure to thrive: a cost/effectiveness analysis
Insights
Medical placement homes (MPH) offer a cost-effective alternative to traditional hospitalization for infants with failure to thrive (FTT). MPHs facilitate superior catch-up growth, demonstrating a more efficient approach to managing infant FTT.
Area of Science:
- Pediatrics
- Growth and Development
- Child Health
Background:
- Failure to thrive (FTT) is a common reason for infant hospitalization, often incurring significant costs without clarifying etiology.
- Organic causes of FTT are typically excluded by initial clinical assessments.
- Traditional diagnostic hospitalizations for FTT are lengthy and expensive.
Purpose of the Study:
- To compare the effectiveness and cost-efficiency of medical placement homes (MPH) versus traditional diagnostic hospitalization for infants with FTT.
- To evaluate catch-up growth rates and weight gain in infants managed in MPH settings.
Main Methods:
- A study compared 17 infants in MPHs with 18 infants in traditional hospital settings.
- Infants in both groups were under one year of age and similar in pre-admission characteristics.
- Weight gain and cost per 100 grams were analyzed for both groups.
Main Results:
- The MPH group exhibited significantly greater weight gain (362g in hospital + 1270g in MPH) compared to the hospital-only group (276g).
- MPH infants showed accelerated catch-up growth (29 gms/day above expectation) versus the comparison group (16 gms/day).
- Weight gain was substantially more cost-effective in MPHs (+308 per 100g) compared to traditional hospitalization (+1,635 per 100g).
Conclusions:
- Medical placement homes provide a more effective and economical approach for managing infant failure to thrive.
- MPHs promote superior catch-up growth compared to traditional hospitalizations.
- The cost-effectiveness of MPHs suggests a potential shift away from lengthy hospital stays for FTT workups.
Abstract:
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)