Medical Utilization and Costs in Preterm Infants in the First 6 Years of Life After Discharge From Neonatal Intensive Care Unit: A Nationwide Population-Based Study in Korea

Abstract

Background The improvement in the survival rate of preterm infants has paradoxically raised the risk of morbidities in childhood. Our objectives were to assess the medical utilization and costs in preterm infants following discharge from the neonatal intensive care unit in the first 6 years of life. Methods We conducted a population-based study using the National Health Information Database (2011–2017) provided by the Korean National Health Insurance Service (NHIS). A total of 361,190 children born in Korea between January 1 and December 31, 2011 were divided into four groups according to the gestational age at birth: extremely preterm (less than 28 weeks), very preterm (28–31 weeks), moderate to late preterm (32–36 weeks), and full term (37–41 weeks). The cumulative number of outpatient visits, cumulative length of hospital stay, rate of hospital and intensive care unit admissions, and cumulative medical costs for inpatients and outpatients were compared for each gestational age group. Results Earlier gestational age was significantly associated with an increased risk of the cumulative number of outpatient visits, cumulative length of hospital stay, and rate of hospital and intensive care unit admissions for the first 6 years of life. The mean cumulative inpatient and outpatient costs per child significantly decreased with increasing gestational age. When assessed based on population size, the total cumulative medical costs were highest for moderate to late preterm children. Conclusion Earlier gestational age was strongly associated with increased healthcare resource utilization and medical costs. Our findings on the potential long-term socioeconomic impact on public health are expected to aid the development of future health care policies for preterm children.

Rising Public Cost of Preterm Infant Hospitalization: A nationwide observational study in South Korea

“…Earlier GA was strongly associated with increased healthcare resource utilization and medical costs in Korea, especially in the extremely preterm group. 10 The total medical costs of preterm infants steadily increased throughout the study period. In 2008, the Korean Ministry of Health and Welfare established "The Service for National Support of NICU Installation and Management."…”

“…Jin et al, studied rst 6 years medical costs in preterm infants after discharge from NICU in Korea. 10 Rate of hospital admission was 75.6% in infants born less than 28 gestational weeks in 6 years and most of the costs was spent in the rst year after discharge. In our data, we focused more on advanced period and readmission happened 16% in 30 days, 24% in 60 days and 29% in 90 days after discharge in extremely preterm infants.…”

Self-Reported Findings of the Korean Intermittent Exotropia Multicenter Study Questionnaire

“…In our study, preterm birth was found in 8.8% of all patients, and there was a higher rate of preterm birth in those with a younger age at onset which supports the theory of abnormal development of binocular fusion in premature children. Nevertheless, the percentage of preterm birth was not higher than the national preterm birth rate reported in South Korea, which has increased from 5.9% in 2011 to 9.1% in 2021 [28][29][30],…”

Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm

“…It is possible that in general, individuals born preterm had greater health care utilization compared with term-born individuals during the pandemic. However, much of the data suggest that health care resource use by preterm-born individuals is concentrated during early childhood years, and for this ECHO cohort, most participants were aged 6 to 12 years.…”