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Implementation of Family Integrated Care in the Neonatal Intensive Care Unit, University Hospitals Sussex, UK
Natalia Hounsome1, Heike Rabe2,3, Eleanor Turk3
1Department of Global Health and Infection, Brighton and Sussex Medical School, University of Brighton and University of Sussex, Brighton BN1 9PX, UK.
Insights
Family Integrated Care (FICare) implementation in UK NICUs showed potential cost savings. While average NICU stays were similar, FICare reduced high-dependency care days and ventilation durations, suggesting resource efficiency.
Area of Science:
- Neonatal Medicine
- Health Economics
- Family-Centered Care
Background:
- Family Integrated Care (FICare) involves families as equal partners in neonatal care.
- This study evaluated FICare's economic impact in UK neonatal units.
Purpose of the Study:
- To assess the health economics and clinical outcomes of FICare implementation.
- To determine if FICare is resource- and cost-saving for neonatal intensive care units (NICUs).
Main Methods:
- Economic evaluation and clinical outcome audit of NICU admissions in 2021 and 2024.
- Analysis included infants with NICU stays >20 days, using Health Resource Group codes for cost estimation.
Main Results:
- Average NICU stay duration remained similar (47 days) before and after FICare.
- FICare reduced high-dependency care days (13 to 10), invasive ventilation (12%), and CPAP use (26%).
- Total NICU costs decreased from GBP 63,279 to GBP 59,284 per baby.
Conclusions:
- FICare shows potential for resource and cost savings in NICUs.
- Reduced high-dependency care and shorter ventilation durations contribute to efficiency.
- While not statistically significant, trends suggest FICare's economic benefits.
Abstract:
Background/Objectives: Family Integrated Care (FICare) is a model of care for preterm or critically ill infants in which families are considered equal partners with clinical teams and are fully integrated into all aspects of care and decision-making. In this study, we conducted a health economics study of FICare implementation in the UK, as part of the EU-funded international, interdisciplinary, and intersectoral project RISEinFamily. Methods: An economic evaluation of healthcare services and an audit of clinical outcomes for infants admitted to the Royal Sussex County Hospital and the Princess Royal Hospital neonatal units in 2021 (at the start of FICare) and 2024 (when FICare was fully integrated into clinical practice) were conducted. Anonymized data on hospital admissions were downloaded from the hospital database. Infants with a duration of stay in the NICU of more than 20 days were included in the analysis. The cost of NICU stay was estimated using the Health Resource Group codes. Results: The average duration of infants' stay in NICU was similar before and after the implementation of FICare (47 days (SD 29) in 2021 and 47 days (SD 31) in 2024). However, the infants who received FICare spent fewer days in high-dependency care; on average, 10 days in 2024 and 13 days in 2021. The duration of invasive ventilation fell by 12% and the duration of CPAP by 26% after introducing FICare. The total cost per baby stay in NICU was GBP 63,279 (USD 87,021) in 2021 and GBP 59,284 (USD 75,777) in 2024. Conclusions: Although the changes did not reach statistical significance, the study suggests that FICare may be resource- and cost-saving due to reducing infants' stays in high-dependency care.
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