Cost of morbidities in very low birth weight infants.
Cost of morbidities in very low birth weight infants.
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DOI：
10.1016/j.jpeds.2012.07.013
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发表时间：
2013-02
影响因子：
5.1
通讯作者：
Meier, Paula P.
中科院分区：
文献类型：
--
作者：
Johnson, Tricia J.;Patel, Aloka L.;Jegier, Briana J.;Engstrom, Janet L.;Meier, Paula P.
本研究的目的是在极低出生体重儿（VLBW;出生体重<1500 g）的回顾性队列中，确定初始新生儿重症监护室（NICU）住院的直接费用与四种潜在可预防的发病率之间的关系。样本包括2005年7月至2009年6月在拉什大学医学中心出生的425名VLBW婴儿。发病率包括脑损伤、坏死性小肠结肠炎、支气管肺发育不良和迟发性脓毒症。临床和经济数据从该机构的全系统数据仓库和成本核算系统中检索。一个一般的线性回归模型，以确定增量直接成本与每一个发病率。在控制了出生体重、胎龄和社会人口统计学特征后，脑损伤的存在与12，048美元的死亡相关。（p=0.005）直接费用增加;坏死性小肠结肠炎，15，440美元（p=0.005）增加;支气管肺发育不良增加31，565美元（p<0.001）;迟发性脓毒症增加10，055美元（p<0.001）。发病率的绝对数量也与显著更高的成本相关。本研究首次对极低出生体重儿这四种疾病在新生儿重症监护病房住院期间的直接费用进行了集体评估。与这些发病率相关的增量成本很高，这些数据可以为未来评估干预措施以预防或减少这些昂贵的发病率的研究提供信息。
The objective of this study was to determine the association between direct costs for the initial neonatal intensive care unit (NICU) hospitalization and four potentially preventable morbidities in a retrospective cohort of very low birth weight infants (VLBW; <1500g birth weight). The sample included 425 VLBW infants born alive between July 2005 and June 2009 at Rush University Medical Center. Morbidities included brain injury, necrotizing enterocolitis, bronchopulmonary dysplasia, and late onset sepsis. Clinical and economic data were retrieved from the institution’s system-wide data warehouse and cost accounting system. A general linear regression model was fit to determine incremental direct costs associated with each morbidity. After controlling for birth weight, gestational age, and socio-demographic characteristics, the presence of brain injury was associated with a $12,048 (p=0.005) increase in direct costs; necrotizing enterocolitis with a $15,440 (p=0.005) increase; bronchopulmonary dysplasia with a $31,565 (p<0.001) increase; and late onset sepsis with a $10,055 (p<0.001) increase in direct costs. The absolute number of morbidities was also associated with significantly higher costs. This study provides the first collective estimates of the direct costs during the NICU hospitalization for these four morbidities in VLBW infants. The incremental costs associated with these morbidities were high, and these data can inform future studies evaluating interventions to prevent or reduce these costly morbidities.
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