699: Title:10 year study on the economic burden of prematurity in the united states

Abstract

Studies have demonstrated that hospital costs, mortality and morbidity decrease with increasing gestational age at birth. Efforts have thus been made to reduce the rate of prematurity. We sought to evaluate the recent trend of hospital costs associated with preterm births. We conducted a retrospective population-based study using data from the Nationwide Inpatient Sample (NIS). The study population included all births in the dataset occurring between 2006 and 2015 in the United States and weighted to provide national estimates on annual trends and costs. Prematurity status was defined using the International Classification of Diseases codes. Direct hospital costs of each newborn admission were obtained within the dataset. Both total costs associated with preterm and term births significantly increased over the 10-year period. In 2006, a single preterm and term birth cost on average $43,846 and $3,746 US, respectively. These numbers rose to $100,569 and $6,822 per birth in 2015. The majority of the increase in cost attributed to premature infants was due to births occurring before 28 completed weeks of gestation, with more than $500,000 being spent on each infant born before 28 weeks. Premature births represent less than 10% of all births, however, providing care to these infants incurred direct hospital costs of $29.8 billion, almost 60% of the $52.9 billion spent on all newborns in 2015. The proportion of direct in-hospital birth costs attributed to premature deliveries has only been increasing with time. Direct hospital costs associated with births are significantly increasing over time, and this largely due to premature deliveries. Efforts aiming to reduce prematurity rates could have the largest impact on the economic costs of prematurity.