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CC BY-NC-ND 4.0 · AJP Rep 2019; 09(01): e76-e83
DOI: 10.1055/s-0039-1683934
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Incremental Cost of Prematurity by Week of Gestational Age

Eileen M. Walsh
1   Division of Research, Kaiser Permanente, Oakland, California
,
Sherian X. Li
1   Division of Research, Kaiser Permanente, Oakland, California
,
Libby K. Black   *
2   Global Health Outcomes, Recro Pharma, Malvern, Pennsylvania
,
Michael Kuzniewicz   *
1   Division of Research, Kaiser Permanente, Oakland, California
2   Global Health Outcomes, Recro Pharma, Malvern, Pennsylvania
› Author Affiliations
Further Information

Publication History

23 October 2018

30 December 2018

Publication Date:
19 March 2019 (online)

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Abstract

Objective This study was aimed to compare health care costs and utilization at birth through 1 year, between preterm and term infants, by week of gestation.

Methods A cross-sectional study of infants born at ≥ 23 weeks of gestational age (GA) at Kaiser Permanente Northern California facilities between 2000 and 2011, using outcomes data from an internal neonatal registry and cost estimates from an internal cost management database. Adjusted models yielded estimates for cost differences for each GA group.

Results Infants born at 25 to 37 weeks incur significantly higher birth hospitalization costs and experience significantly more health care utilization during the initial year of life, increasing progressively for each decreasing week of gestation, when compared with term infants. Among all very preterm infants (≤ 32 weeks), each 1-week decrease in GA is associated with incrementally higher rates of mortality and major morbidities.

Conclusion We provide estimates of potential cost savings that could be attributable to interventions that delay or prevent preterm delivery. Cost differences were most extreme at the lower range of gestation (≤ 30 weeks); however, infants born moderately preterm (31–36 weeks) also contribute substantially to the burden, as they represent a higher proportion of total births.

Keywords

preterm birth - health care costs - utilization - neonatal intensive care

* Study contributions while at Glaxo Smith Kline, Value Evidence & Outcomes, NC, USA.


 

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