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The financial burden on families of infants requiring neonatal intensive care
Brian C King1, Meredith E Mowitz2, John A F Zupancic3
1Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Division of Newborn Medicine, Texas Children's Hospital, Houston, TX, USA.
Insights
The financial burden on families with infants in neonatal intensive care units (NICUs) is significant, impacting care. More research is needed to understand the full out-of-pocket costs for these families.
Area of Science:
- Medical Economics
- Neonatology
- Public Health
Background:
- Neonatal intensive care unit (NICU) costs are increasingly studied, but family financial impact is less understood.
- Families face substantial financial strain during and after a NICU stay.
Purpose of the Study:
- To systematically review and summarize the financial burden on families due to neonatal intensive care.
- To identify gaps in research regarding out-of-pocket costs for NICU patients' families.
Main Methods:
- Systematic literature review of Pubmed/Medline and EMBASE databases from 1990-2020.
- Included studies reporting out-of-pocket costs or qualitative financial burden estimates for families.
- Analyzed 44 studies meeting inclusion criteria, with 25 providing quantitative cost estimates.
Main Results:
- Direct non-medical costs and loss of productivity were primary cost focuses.
- Few studies estimated insurance cost-sharing burdens.
- Available data indicate significant financial stress for families, potentially affecting patient care.
Conclusions:
- Out-of-pocket costs associated with neonatal intensive care are substantial for families.
- There is a need for comprehensive studies on the total financial impact.
- Understanding these costs is crucial for addressing their direct effect on high-risk infant care.
Abstract:
While the high costs of neonatal intensive care have been a topic of increasing study, the financial impact on families have been less frequently reported or summarized. We conducted a systematic review of the literature using Pubmed/Medline and EMBASE (1990-2020) for studies reporting estimates of out-of-pocket costs or qualitative estimates of financial burden on families during a neonatal intensive care unit stay or after discharge. 44 studies met inclusion criteria, with 25 studies providing cost estimates. Cost estimates primarily focused on direct non-medical out-of-pocket costs or loss of productivity, and there was a paucity of cost estimates for insurance cost-sharing. Available estimates suggest these costs are significant to families, cause significant stress, and may impact care received by patients. More high-quality studies estimating the entirety of out-of-pocket costs are needed, and particular attention should be paid to how these costs directly impact the care of our high-risk population.
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