Abstract
Despite notable advances in prenatal and neonatal care, respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) remain important complications of preterm births, and their long-term sequelae are poorly understood. To describe health care utilization and costs over a 16- to 25-year follow-up period in a cohort of preterm infants with respiratory complications. Using provincial health administrative databases from Quebec, a cohort of individuals who were born prematurely with complications of RDS and⁄or BPD between 1983 and 1992 were identified. From these databases, which cover all Quebec residents, health services use, medication prescriptions, associated diagnoses and costs were tabulated. A total of 3442 subjects with respiratory complications following preterm birth were identified, of whom 773 had been diagnosed with BPD and 2669 had RDS without BPD. Asthma was diagnosed twice as frequently (1.7 to 2.4 times) in the BPD group compared with the RDS group, with more frequent hospital readmission, and outpatient and emergency room visits. Although respiratory causes remained the main reason for consultation in both groups, 3.7% and 3.4% of the outpatient visits were for mental or psychological ailments, such as depression, attention deficit hyperactivity disorder or dysthymia for the BPD and RDS groups, respectively. BPD patients experienced more hospital admissions, outpatient and emergency rooms visits, and were more likely to suffer from respiratory illnesses and to use respiratory drugs than RDS patients. Neurological and psychiatric complications occurred at a high frequency in both RDS and BPD subjects, and were associated with significant use of antipsychotic and antidepressant medications.
Highlights
IntRoDuCtIon: Despite notable advances in prenatal and neonatal care, respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) remain important complications of preterm births, and their longterm sequelae are poorly understood. oBJECtIVE: To describe health care utilization and costs over a 16- to 25-year follow-up period in a cohort of preterm infants with respiratory complications
The present study aimed to describe the health care cost and health care utilization over a 16- to 25-year period in a preterm cohort with respiratory complications (RDS and BPD) born between 1983 and 1992 in Quebec
The International Classification of Diseases, Ninth Revison (ICD-9) codes for diagnoses [3] have been used in these databases since April 1, 1981, and ICD-10 codes since April 1, 2006. These databases were used to identify all subjects with a preterm birth, defined as a gestational age
Summary
Data presented as mean ± SD unless otherwise indicated. BPD Bronchopulmonary dysplasia; RDS Respiratory distress syndrome. Asthma was diagnosed twice as frequently (1.7 to 2.4 times) in the BPD group compared with the RDS group, during hospital readmission, outpatient or emergency room visits. The most frequent medical and surgical specialties consulted for all medical visits in the outpatient settings (which include outpatient departments and private offices) were pediatrics (27.9% and 29.5% for BPD and RDS, respectively), otorhinolaryngology (5.7% and 5.2%), ophthalmology (5.7% and 3.9%), respirology (5.5% and 0.6%) and psychiatry (4.5% and 3.3%). The latter two were found to be statistically different between the two groups. TabLe 2 Health care utilization: Number of hospitalizations, outpatient and emergency room visits, and rate of most frequent diagnoses
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