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Updated: Jul 30, 2026

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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Comparing nursing costs for preterm infants receiving conventional vs. developmental care
P Petryshen1, B Stevens, J Hawkins
1St. Michael's Hospital, Toronto, Ontario.
Summary
Developmental care for very low birth weight (VLBW) infants, focusing on environment and sleep, reduced NICU stays and costs. This approach improved infant stability and led to significant cost savings per infant.
Area of Science:
- Neonatal intensive care
- Developmental pediatrics
- Health economics
Background:
- Very low birth weight (VLBW) infants incur substantial healthcare costs, representing a significant portion of national health expenditures.
- Conventional neonatal intensive care unit (NICU) practices may not fully address the complex needs of VLBW infants, potentially leading to longer hospital stays and higher costs.
Purpose of the Study:
- To evaluate the impact of a developmental care approach on VLBW infants' physiologic stability, length of NICU stay, and associated healthcare costs.
- To compare outcomes between VLBW infants receiving developmental care versus conventional NICU care.
Main Methods:
- A comparative study involving 120 VLBW infants, with 60 receiving developmental care and 60 receiving conventional NICU care.
- Developmental care strategies included light/noise management, coordinated interventions to minimize sleep interruptions, and specific positioning/bundling techniques.
- Outcome measures included physiologic stability, NICU length of stay, and cost savings within the first 35 days of life.
Main Results:
- Infants in the developmental care group demonstrated improved physiologic stability compared to the conventional care group.
- The developmental care group experienced fewer days in the NICU.
- Earlier transfer to a transitional unit and lower nursing intensity needs in the developmental group resulted in an average cost saving of $4,340 per infant.
Conclusions:
- Developmental care is an effective strategy for improving outcomes in VLBW infants, including enhanced physiologic stability and reduced NICU length of stay.
- Implementing developmental care in the NICU setting can lead to significant cost savings for healthcare systems.
- This approach highlights the importance of optimizing the infant's environment and care coordination for better VLBW infant outcomes and resource utilization.

