Abstract
Background: Preterm birth disparities with their associated geographic, socioeconomic status and race/ethnicity factors are among the most widely recognized and least understood phenomena in the study of reproductive health. Previous studies have focused on total cost; few studies have disaggregated total charges into their components for both the preterm infants and their mothers or compared such costs to full-term births.
Aim: To quantify and disaggregate initial hospital charges among preterm infants and their mothers compared to full-term controls.
Methods: The study populations were comprised of mother-infant dyads that included 746 preterm cases and 3372 controls. Data were obtained from the Geisinger outpatient electronic health record, Geisinger Medical Center billing records, and the inpatient pharmacy billing database in the Geisinger Health System. Measures were derived for hospital charges, lengths of stay for infants and mothers, and the mean delivery hospitalization charges for the subset of infants and mothers who had the most frequent diagnoses, procedures, and drug classes.
Results: The mean hospitalization charges ($103,000 versus $7,000) and the length of stay (16.1 days versus 2.3 days) were substantially higher for preterm infants versus controls. Extreme preterm infants (< 26 weeks) accounted for 1.3% of the total preterm births and approximately 20% of the total initial hospital charges and near term infants (33–36 weeks) accounted for approximately 14% of total births and 30% of the total charges. The most frequent inpatient medical conditions were five to 17 times as frequent among preterm infants as among the controls. The most frequent procedures and drug classes were also generally more prevalent among preterm infants. Preterm infants had generally higher charges related to inpatient diagnoses, procedures and medication utilization. The mean hospitalization charges ($23,000 versus $15,000) and length of stay (i.e., 5.1 days versus 2.3 days) was also higher among the preterm mothers than controls. Medication utilization was compared between the two groups and preterm mothers had higher charges related to inpatient diagnoses, procedures and medication utilization compared to controls.
Conclusions: The most extreme premature (4.3%) of preterm births accounted for 47% of the total preterm hospital charges. Overall costs increased as gestational ages decreased.
- Received May 27, 2010.
- Accepted May 27, 2010.
