Cost of neonatal care according to gestational age at birth and survival status☆,☆☆,★
Section snippets
Population
The database of the regional neonatal intensive care unit at the University of Alabama at Birmingham’s University Hospital was used to define the population of premature infants born in the study institutions. Data were collected for all infants born between 24 and 32 weeks’ gestation during the years 1989 through 1992, excluding infants that may have been admitted to the well-baby nursery. All nonsurviving infants born at ≥33 weeks’ gestation were identified from the mortality records of
Results
There were 974 infants born between 24 and 32 weeks’ gestation at University Hospital from October 1989 through December 1992. Among these, 281 were excluded because they received a portion of their care at a hospital other than the University Hospital or the Children’s Hospital of Alabama. An additional 72 were excluded because the obstetric estimate of gestational age was ≥3 weeks different from the postnatal estimate of gestational age according to Ballard examination. Among the 300 infants
Comment
This study is the first to examine the cost of initial hospital care according to survival for infants across a broad range of gestational ages. It represents a vast undertaking with remarkable cooperation from 2 hospitals and numerous physician billing departments that resulted in a comprehensive data set of actual charges for 958 infants. The study gives perspective to the high costs of very low gestational age infants by placing them in the larger context of the population of neonates of all
Acknowledgements
We are grateful for the assistance of Melanie Salsgiver, RN, head nurse of the regional neonatal intensive care unit, in identifying infant charges in the nearly 300 combined mother-infant accounts for term infants and to the billing and administrative personnel of University Hospital and the Children’s Hospital of Alabama for their assistance and cooperation. We acknowledge the physicians in the departments of pediatrics, radiology, and surgery for generously sharing billing data on their
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Supported by contract 282-92-0055 from the Agency for Health Care Policy and Research.
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Reprint requests: Elaine B. St. John, MD, Associate Professor of Pediatrics, Division of Neonatology, 525 NHB, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233-7335.
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0002-9378/2000 $12.00 + 06/1/101830