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Neonatal intensive care and cost effectiveness
1St. Joseph's Health Centre, London, Ont.
Insights
Neonatal intensive care has halved infant mortality for low birth weight newborns but is costly. Despite cost concerns, its value is favorable, especially for infants weighing 1000-1500g.
Area of Science:
- Neonatal medicine
- Health economics
Background:
- Neonatal intensive care has significantly reduced mortality rates for newborns weighing less than 1500 grams.
- Despite improved outcomes, the high cost of neonatal intensive care has led to discussions about cost containment.
Purpose of the Study:
- To review the literature on the cost-effectiveness of neonatal intensive care.
- To compare the costs of neonatal intensive care with other expensive medical programs.
Main Methods:
- Literature review of studies on neonatal intensive care costs.
- Analysis of cost-effectiveness data for neonatal intensive care and other medical programs.
Main Results:
- Neonatal intensive care costs compare favorably, particularly for infants with birth weights between 1000 and 1500 grams.
- The overall prevalence of infant disabilities has not significantly changed despite advances in neonatal care.
Conclusions:
- Decisions to limit neonatal intensive care based on birth weight or gestational age require careful consideration.
- Further research is needed on the long-term outcomes of very low birth weight infants and cost-effectiveness of medical programs.
Abstract:
During the past decade the rate of death among newborns weighing less than 1500 g at birth has decreased by approximately half. This dramatic reduction has resulted from the application of research findings and technologic advances, but it has proved expensive. Perhaps as a consequence of articles demonstrating the costs as well as the recognition that the overall prevalence of disabilities in infants is relatively unchanged, neonatal intensive care has recently been viewed as a possible area for cost containment. We reviewed the literature on the cost of neonatal intensive care and the limited information on other expensive medical programs and found that the cost of neonatal intensive care compared favourably, especially for infants whose birth weight was 1000 to 1500 g. Better information on the outcome of infants of very low birth weight and comparable rigorous studies of the cost effectiveness of other expensive medical programs are required, and other less easily quantified factors must be considered before decisions are made to limit neonatal intensive care on the basis of gestational age or birth weight.
