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Long-Term Societal Costs After Births Before 24 Weeks of Gestation in Sweden
Chatarina Löfqvist1,2,3, Boubou Hallberg4, Ulrika Sjöbom1,3
1Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
Children born extremely preterm face substantial long-term costs, with initial medical expenses shifting to social support needs as they grow. This highlights the significant financial impact of extremely preterm birth on families and society.
Area of Science:
- Neonatology
- Public Health
- Health Economics
Background:
- Extremely preterm birth (before 24 weeks gestation) is linked to significant health challenges and ongoing support requirements.
- Understanding the long-term economic burden is crucial for resource allocation and policy development.
Purpose of the Study:
- To estimate the total long-term medical and non-medical costs for children born extremely preterm in Sweden.
- To analyze cost trajectories throughout childhood from a societal perspective.
Main Methods:
- Nationwide register-based study of 344 infants born before 24 weeks gestation (2007-2018) surviving at least one year.
- Linked national health and social insurance data to track costs until 2022.
- Costs analyzed from a societal perspective, reported in 2022 Swedish kronor.
Main Results:
- Average total costs per child were 1.68 million SEK in the first year, predominantly medical (over 80%).
- Non-medical costs, including social support, surpassed medical costs around age four.
- Neonatal morbidities like bronchopulmonary dysplasia and intraventricular hemorrhage correlated with higher long-term costs.
Conclusions:
- Birth before 24 weeks gestation incurs substantial long-term societal costs.
- Initial costs are driven by hospital care, transitioning to social and welfare support needs over time.
Aim:
Extremely preterm birth is associated with high morbidity and long-term support needs. This study estimated long-term medical and non-medical costs throughout childhood among children born before 24 weeks of gestation in Sweden.
Methods:
This nationwide register-based study included 344 infants born before 24 weeks of gestation in Sweden between 2007 and 2018 who survived at least one year. Individual-level data from national health registers and social insurance records were linked to estimate costs of hospital care, outpatient care, prescribed drugs and parental support until the end of 2022. Costs were analysed from a societal perspective and expressed in 2022 Swedish kronor.
Results:
The mean follow up time was 7.8 years. Average total costs per child were 1.68 million Swedish kronor in the first year of life, with medical care accounting for more than 80% of expenditures. Non-medical costs increased during childhood and exceeded medical costs from approximately four years of age. Neonatal morbidities, including bronchopulmonary dysplasia, treated retinopathy of prematurity, and severe intraventricular haemorrhage, were associated with sustained long-term costs.
Conclusion:
Birth before 24 weeks of gestation was linked to high long-term costs. Early costs were related to hospital care, while long-term costs increasingly reflected social and welfare support.
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