Trends In Complicated Newborn Hospital Stays &amp; Costs, 2002–2009: Implications For The Future

Fowler, Tara Trudnak; Fairbrother, Gerry; Owens, Pamela; Garro, Nicole; Pellegrini, Cynthia; Simpson, Lisa

doi:10.5600/mmrr.004.04.a03

Cited by 15 publications

(9 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neonatologists may consider the high cost of neonatal intensive care in their own decisions about when and whether to offer intensive care (Fowler et al 2014). Two points are relevant to arguments about cost and cost-effectiveness.…”

Section: Age and Gestational Age Biasesmentioning

confidence: 99%

Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?

Haward

Janvier

Moore

et al. 2020

The American Journal of Bioethics

View full text Add to dashboard Cite

In a crisis, societal needs take precedence over a patient's best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating extremely premature babies should be altered to free-up ventilators. Some adults who need ventilators will have a survival rate higher than some extremely premature babies. But surviving babies will likely live longer, maximizing lifeyears. Empiric evidence demonstrates that these babies can derive significant survival benefits from ventilation when compared to adults. When "triaging" or choosing between patients, justice demands fair guidelines. Premature babies do not deserve special consideration; they deserve equal consideration. Solidarity is crucial but must consider needs specific to patient populations and avoid biases against people with disabilities and extremely premature babies.

show abstract

Section: Age and Gestational Age Biasesmentioning

confidence: 99%

Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?

Haward

Janvier

Moore

et al. 2020

The American Journal of Bioethics

View full text Add to dashboard Cite

show abstract

“…For example, each year there are *380,000 preterm births in the United States that cost an estimated $26 billion, the majority of which are covered by Medicaid. 9 Costs for other poor birth outcomes, including low birth weight, respiratory distress, and jaundice, have steadily increased over the past 10 years, with higher proportions of deliveries and infant care also covered by Medicaid. 10 Refugees can access Medicaid coverage if eligible, and indeed many refugees use Medicaid after the temporary Refugee Medical Assistance coverage is exhausted.…”

Section: Introductionmentioning

confidence: 99%

Reproductive Health Outcomes in African Refugee Women: A Comparative Study

Agbemenu

Auerbach

Murshid

et al. 2019

Journal of Women's Health

View full text Add to dashboard Cite

Background: African refugee women in the United States are at risk of poor reproductive health outcomes; however, examination of reproductive health outcomes in this population remains inadequate. We compared:(1) prepregnancy health and prenatal behavior; (2) prenatal history and prenatal care utilization; and (3) labor and birth outcomes between African refugee women and U.S.-born Black and White women. Methods: A secondary data analysis of enhanced electronic birth certificate data was used. Univariate comparisons using chi-squared tests for dichotomous variables and analysis of variance and/or Kruskal-Wallis tests for continuous variables were conducted for Refugee versus Black versus White women. A p-value <0.05 was considered statistically significant. Results: From 2007 to 2016, 789 African refugee, 17,487 Black, and 59,615 White women in our population gave birth. African refugees experienced more favorable health outcomes than U.S.-born groups on variables examined. Compared to U.S.-born women, African refugee women had fewer prepregnancy health risks ( p < 0.001), fewer preterm births ( p < 0.001), fewer low birth weight infants ( p < 0.001), and higher rates of vaginal deliveries ( p < 0.001). These favorable outcomes occurred despite later initiation of prenatal care ( p < 0.001) and lower scores of prenatal care adequacy among refugee women compared to U.S.-born groups ( p < 0.001). Conclusions:The healthy immigrant effect appears to extend to reproductive health outcomes in our studied population of African refugee women. However, based on our data, targeted, culturally-congruent education surrounding family planning and prenatal care is recommended. Insight from reproductive health care experiences of African refugee women can provide understanding of the protective factors contributing to the healthy immigrant effect in reproductive health outcomes, and knowledge gained can be utilized to improve outcomes in other at-risk groups.

show abstract

“…However, recent data indicate pediatric (0-18 y) spending is increasing faster than total population health spending (6). One percent of children, including extremely low-birth-weight infants, consume 10 times the financial resources, most of which is as a result of in-patient hospitalization (7)(8)(9)(10)(11). Further, nearly half of all births are within the Medicaid program, creating a strong federal incentive to regulate neonatal costs and payment (12).…”

mentioning

confidence: 99%

Toward development of evidenced-based quality parameters: What gets counted and who gets paid?

2016

View full text Add to dashboard Cite

and motivate changes in physician behavior and systemsbased practice.Pediatricians must adopt an active role as advisors of these ACA metrics, participating in deliberations about which measures are worth universally adopting. Without pediatric input into these decisions, there is a chance to create a system which rewards metrics over actual patient benefit. Data on pay-forperformance incentives for hypertension management in adults, for example, demonstrated improved compliance with guidelines but no impact on blood pressure levels or rates of stroke (24). Specific patient focused studies on best practice and health care metrics with cost-effectiveness data which are replicable in multiple settings are necessary prior to policy changes.

show abstract

Trends In Complicated Newborn Hospital Stays & Costs, 2002–2009: Implications For The Future

Cited by 15 publications

References 8 publications

Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?

Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?

Reproductive Health Outcomes in African Refugee Women: A Comparative Study

Toward development of evidenced-based quality parameters: What gets counted and who gets paid?

Contact Info

Product

Resources

About