Estimates of healthcare spending for preterm and low-birthweight infants in a commercially insured population: 2008–2016

Abstract

The growth in healthcare spending is an important topic in the United States, and preterm and low-birthweight infants have some of the highest healthcare expenditures of any patient population. We performed a retrospective cohort study of spending in this population using a large, national claims database of commercially insured individuals. A total of 763,566 infants with insurance coverage through Aetna, Inc. for the first 6 months of post-natal life were included, and received approximately $8.4 billion (2016 USD) in healthcare services. Infants with billing codes indicating preterm status (<37 weeks, n = 50,511) incurred medical expenditures of $76,153 on average, while low-birthweight status (<2500 g) was associated with average spending of $114,437. Infants born at 24 weeks gestation (n = 418) had the highest per infant average expenditures of $603,778. Understanding the drivers of variation in costs within gestational age and birthweight bands is an important target for future studies.

Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units

“…[2][3][4][5][6][7][8][9][11][12][13][14][15] Serious but potentially preventable NICU morbidities are a consequence of these immature organs and pathways and are associated with increased rates of rehospitalizations and neurodevelopmental problems, [16][17][18][19][20][21][22] as well as higher costs due to longer hospitalizations and additional resource utilization. 23,24 The estimated healthcare cost in the first 6 months of life for VLBW infants is $332,225 (2019 USD) compared to $7247 (2019 USD) for term infants. 24 After the NICU hospitalization, the economic burden continues with higher healthcare and educational costs that are borne by families of VLBW infants and society at large.…”

“…23,24 The estimated healthcare cost in the first 6 months of life for VLBW infants is $332,225 (2019 USD) compared to $7247 (2019 USD) for term infants. 24 After the NICU hospitalization, the economic burden continues with higher healthcare and educational costs that are borne by families of VLBW infants and society at large. [25][26][27] Whereas the immaturity of these organs and pathways is not modifiable, mother's own milk (MOM; excludes donor human milk (DHM)) feedings optimize their growth and development while simultaneously preventing or reducing the impact of noxious NICU stressors.…”

Extremely premature infants, scarcity and the COVID‐19 pandemic

“…First, the enormous cost of premature infant care in the United States has recently been elucidated with impressive summary graphics 4 . These data highlight the challenges of population health management and prioritising value.…”

Specificity of International Classification of Diseases codes for bronchopulmonary dysplasia: an investigation using electronic health record data and a large insurance database

“…Procedure and diagnostic codes are often used as a surrogate for the clinical outcomes of interest because they are routinely collected, easily accessible, and cover a wide range of clinical conditions. For example, the most recent version of the International Classification of Diseases (ICD), 10th edition, provides over 70,000 procedure codes and over 69,000 diagnosis codes [ 5 ], and ICD codes have previously been used to investigate questions in neonatal and perinatal medicine [ 6 – 9 ].…”