Hospital Utilization and Costs Among Preterm Infants by Payer: Nationwide Inpatient Sample, 2009

Barradas, Danielle T.; Wasserman, Martin P.; Daniel-Robinson, Lekisha; Bruce, Marino A.; DiSantis, Katherine Isselmann; Navarro, Frederick H.; Jones, Warren A.; Manzi, Nadine M.; Smith, Mark W.; Goodness, Brian M.

doi:10.1007/s10995-015-1911-y

Cited by 37 publications

(49 citation statements)

References 11 publications

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“…For infants admitted to the regular newborn nursery, we used nationally representative per-admission cost estimates from the published literature. 22 Physician professional fees for the hospitalization, based on information derived from the ALPS case report forms, were based on Centers for Medicare & Medicaid Services 19 reimbursement levels for each day of stay and non-bundled procedure.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of Antenatal Corticosteroid Therapy vs No Therapy in Women at Risk of Late Preterm Delivery

et al. 2019

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IMPORTANCE Administration of corticosteroids to women at high risk for delivery in the late preterm period (34–36 weeks’ gestation) improves short-term neonatal outcomes. The cost implications of this intervention are not known. OBJECTIVE To compare the cost-effectiveness of treatment with antenatal corticosteroids with no treatment for women at risk for late preterm delivery. DESIGN, SETTING, AND PARTICIPANTS This secondary analysis of the Antenatal Late Preterm Steroids trial, a multicenter randomized clinical trial of antenatal corticosteroids vs placebo in women at risk for late preterm delivery conducted from October 30,2010, to February 27,2015. took a third-party payer perspective. Maternal costs were based on Medicaid rates and included those of betamethasone, as well as the outpatient visits or inpatient stay required to administer betamethasone. All direct medical costs for newborn care were included. For infants admitted to the neonatal intensive care unit, comprehensive daily costs were stratified by the acuity of respiratory illness. For infants admitted to the regular newborn nursery, nationally representative cost estimates from the literature were used. Effectiveness was measured as the proportion of infants without the primary outcome of the study: a composite of treatment in the first 72 hours of continuous positive airway pressure or high-flow nasal cannula for 2 hours or more, supplemental oxygen with a fraction of inspired oxygen of 30% or more for 4 hours or more, and extracorporeal membrane oxygenation or mechanical ventilation. This secondary analysis was initially started in June 2016 and revision of the analysis began in May 2017. EXPOSURES Bethamethasone treatment. MAIN OUTCOMES AND MEASURES Incremental cost-effectiveness ratio. RESULTS Costs were determined for 1426 mother-infant pairs in the betamethasone group (mean [SD] maternal age, 28.6 [6.3] years; 827 [58.0%] white) and 1395 mother-infant pairs in the placebo group (mean [SD] maternal age, 27.9 [6.2] years; 794 [56.9%] white). Treatment with betamethasone was associated with a total mean (SD) woman-infant-pair cost of $4681 ($5798), which was significantly less than the mean (SD) amount of $5379 ($8422) for women and infants in the placebo group (difference, $698; 95% Cl, $186-$1257; P = .02). The Antenatal Late Preterm Steroids trial determined that betamethasone use is effective: respiratory morbidity deceased by 2.9% (95% Cl, −0.5% to −5.4%). Thus, the cost-effectiveness ratio was −23 986. Inspection of the bootstrap replications confirmed that treatment was the dominant strategy in 5000 samples (98.8%). Sensitivity analyses showed that these results held under most assumptions. CONCLUSIONS AND RELEVANCE The findings suggest that antenatal betamethasone treatment is associated with a statistically significant decrease in health care costs and with improved outcomes; thus, this treatment may be an economically desirable strategy.

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Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of Antenatal Corticosteroid Therapy vs No Therapy in Women at Risk of Late Preterm Delivery

et al. 2019

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“…Preterm birth, the most common precursor to infant mortality, is associated with exorbitantly high costs primarily borne by Medicaid. Barradas et al (2016) reported the total costs of infant birth hospitalization and re-hospitalization in 2009 at over $13 billion, of which the 9.1% preterm or low birthweight infants account for 43.4% of costs (Barradas et al 2016). …”

Section: Introductionmentioning

confidence: 99%

Enhancing Healthier Birth Outcomes by Creating Supportive Spaces for Pregnant African American Women Living in Milwaukee

Mkandawire‐Valhmu

Lathen

Baisch

et al. 2018

Matern Child Health J

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Objectives Nationwide, African American women report higher stress levels and less access to pre- and postnatal resources. Wisconsin mirrors national infant mortality trends that show a persistent four-decade gap in infant survival between African American and White populations. The objective of the Milwaukee Birthing Project (MBP) was to implement a community-based health promotion intervention to improve birth outcomes for pregnant, low-income African American women, evaluate its effectiveness, and document its usefulness to inform development of future interventions. The project involved a mentoring and supportive relationship between 28 volunteer mentors (Sister Friends) and 20 pregnant women (Little Sisters). Methods The project implementation and evaluation were informed by the lifecourse perspective and a postcolonial feminist framework. Thematic analysis was used to analyze ethnographic data from monthly meetings and interviews with pregnant Little Sisters and Sister Friends. Results Our findings showed patterns both in community spaces and spaces created during the MBP. Program spaces contrasted with everyday life spaces and allowed women to experience community support. Based on our analysis, we classify these spaces as: (1) community spaces lacking support, (2) safe spaces of belonging and understanding, (3) spaces that foster meaningful interaction, and (4) safe, supportive spaces for other women in the future. Conclusions for Practice Future interventions should consider intentionally developing safe spaces to attain health goals. From a postcolonial feminist perspective, the voices of women who are at greatest risk for experiencing poor birth outcomes are crucial to the development of effective policies.

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“…While only representing 8% of births in population-based data from the US, preterm or low-birth weight infants accounted for 47% of the total annual expenditure for all births (2, 3). …”

Section: Bronchopulmonary Dysplasia (Bpd)mentioning

confidence: 99%

Imaging Bronchopulmonary Dysplasia—A Multimodality Update

2017

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Bronchopulmonary dysplasia is the most common form of infantile chronic lung disease and results in significant health-care expenditure. The roles of chest radiography and computed tomography (CT) are well documented but numerous recent advances in imaging technology have paved the way for newer imaging techniques including structural pulmonary assessment via lung magnetic resonance imaging (MRI), functional assessment via ventilation, and perfusion MRI and quantitative imaging techniques using both CT and MRI. New applications for ultrasound have also been suggested. With the increasing array of complex technologies available, it is becoming increasingly important to have a deeper knowledge of the technological advances of the past 5–10 years and particularly the limitations of some newer techniques currently undergoing intense research. This review article aims to cover the most salient advances relevant to BPD imaging, particularly advances within CT technology, postprocessing and quantitative CT; structural MRI assessment, ventilation and perfusion imaging using gas contrast agents and Fourier decomposition techniques and lung ultrasound.

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Hospital Utilization and Costs Among Preterm Infants by Payer: Nationwide Inpatient Sample, 2009

Cited by 37 publications

References 11 publications

Cost-effectiveness of Antenatal Corticosteroid Therapy vs No Therapy in Women at Risk of Late Preterm Delivery

Cost-effectiveness of Antenatal Corticosteroid Therapy vs No Therapy in Women at Risk of Late Preterm Delivery

Enhancing Healthier Birth Outcomes by Creating Supportive Spaces for Pregnant African American Women Living in Milwaukee

Imaging Bronchopulmonary Dysplasia—A Multimodality Update

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