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J Perinatol. 2018 Jun;38(6):734-741. doi: 10.1038/s41372-018-0055-5. Epub 2018 Feb 15.

Health-care spending and utilization for children discharged from a neonatal intensive care unit.

Author information

1
Department of Pediatrics, University at Buffalo, Buffalo, NY, USA. dkuo@upa.chob.edu.
2
Complex Care Service, Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
3
Children's Hospital Association, Lenexa, KS, USA.
4
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
5
Arkansas Children's Research Institute, Little Rock, AR, USA.
6
Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.

Abstract

OBJECTIVES:

To describe health-care spending and utilization for infants discharged from the neonatal intensive care unit (NICU).

STUDY DESIGN:

Retrospective cohort analysis of 4973 NICU graduates in the Truven MarketScan Medicaid database, with follow-up to the third birthday. Health-care spending and utilization after NICU discharge were assessed. Using logistic regression, we assessed clinical characteristics associated with hospitalization and emergency department (ED) visits.

RESULTS:

Most (69.5%) post-NICU spending occurred within the first year [$33,276 per member per year]. Inpatient care accounted for most (71.6%) of the 3-year spending. The percentages of infants with a 1-year readmission or ED visit were 36.8% and 63.7%, respectively. Medical technology was associated with the highest likelihoods of hospital [aOR 17.8 (95%CI 12.2-26.0)] and ED use [aOR 2.3 (95%CI 1.8-3.0)].

CONCLUSIONS:

Hospital care accounts for the majority of spending for NICU graduates. Infants with medical technology have the highest risk of hospital and ED use.

PMID:
29449613
DOI:
10.1038/s41372-018-0055-5

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