Abstract
ObjectiveTo examine whether the H-HOPE (Hospital to Home: Optimizing the Preterm Infant’s Environment) intervention reduced birth hospitalization charges yielding net savings after adjusting for intervention costs.Study designOne hundred and twenty-one mother-preterm infant dyads randomized to H-HOPE or a control group had birth hospitalization data. Neonatal intensive care unit costs were based on billing charges. Linear regression, propensity scoring and regression analyses were used to describe charge differences.ResultsMean H-HOPE charges were $10,185 lower than controls (p = 0.012). Propensity score matching showed the largest savings of $14,656 (p = 0.003) for H-HOPE infants, and quantile regression showed a savings of $13,222 at the 75th percentile (p = 0.015) for H-HOPE infants. Cost savings increased as hospital charges increased. The mean intervention cost was $680 per infant.ConclusionsLower birth hospitalization charges and the net cost savings of H-HOPE infants support implementation of H-HOPE as the standard of care for preterm infants.
Highlights
More than half a million infants are born prematurely (
A review of ten studies found that despite study date, location and methodology, birth hospitalization costs among moderate or late preterm infants (32–37 weeks) were at least twice as high compared to full-term infants [9]
While several studies have tested interventions to optimize infant development and behavior initiated during the neonatal intensive care unit (NICU) stay [18,19,20,21,22,23,24,25], we identified only one early intervention study that reported a cost analysis [26]
Summary
The biologic risk of prematurity places infants at greater risk for suboptimal growth and development, poor behavioral organization, and chronic and acute morbidities than fullterm infants. These adverse outcomes result in substantially greater healthcare utilization and expenditures during the birth hospitalization, childhood and into adulthood [2,3,4,5,6]. A review of ten studies found that despite study date, location and methodology, birth hospitalization costs among moderate or late preterm infants (32–37 weeks) were at least twice as high compared to full-term infants [9]. Among preterm infants 29 to 34 weeks gestation born from 2000 to 2009, mean hospitalization costs ranged from $9,740 to $52,998 [10]. Consistent with previous studies, a review of 18 studies found an inverse relationship between costs and gestational age (GA) [11]
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