Abstract
BackgroundComprehensive data are needed to evaluate the burden of low birthweight. Analysis of routine data on health-care utilization during early childhood were used to test the hypothesis that infants with low birthweight have (i) increased inpatient health-care utilization, (ii) higher hospital costs and (iii) different morbidity pattern in early childhood when compared with normal birthweight infants.MethodsChildren born between 2007 and 2013 that were insured at birth with the statutory health insurance AOK PLUS were included (N = 118,166, equaling 49% of the Saxon newborns) and classified into very low (< 1500 g, VLBW), low (1500-2499 g, LBW) birthweight and reference group (> 2500 g). Outcomes were: inpatient health-care utilization quantified by number and length of hospital stays; costs of hospitalizations including medication; reasons of hospitalizations for each year of life (YOL).Results72, 38 and 22% of VLBW-, LBW- and reference group were hospitalized after perinatal period within the first YOL with a more than 5-fold increased risk in VLBW to be hospitalized for hemangioma, convulsions, hydrocephalus, hernia and respiratory problems. Median (IQR) cumulative cost of inpatient care during the first four YOLs was 2953 (1213-7885), 1331 (0–3451) and 0 (0–2062) Euro for respective groups. Inpatient early childhood health-care utilization (after first YOL) was higher in VLBW compared to healthy, normal birth weight infants (RR 3.92 [95%-CI 3.63, 4.23]), residents of rural areas (RR 1.37 [95%-CI 1.35, 1.40]) and in boys (RR 1.31 [95%-CI 1.29, 1.33]).ConclusionThis large population-based birth-cohort study indicates a high clinical and economic burden of low birthweight which is not restricted to the first year of life.
Highlights
Comprehensive data are needed to evaluate the burden of low birthweight
Low birthweight is associated with a distinct hospital morbidity pattern in early childhood that differs from reference infants
Follow-up analysis of our cohort is planned, to have sufficient statistical power to study effects of low birthweight even in adolescents. This large population-based birth cohort study indicates high clinical and economic burden of low birthweight which is not restricted to the first year of life
Summary
Analysis of routine data on health-care utilization during early childhood were used to test the hypothesis that infants with low birthweight have (i) increased inpatient health-care utilization, (ii) higher hospital costs and (iii) different morbidity pattern in early childhood when compared with normal birthweight infants. Most of the relevant data originates either from the Population-based studies on health care utilization that compare low birthweight children with normal birthweight children in a realistic setting and follow. Health insurance data provide valuable information regarding the frequency and regarding the reason for hospitalization and its associated costs. This offers the great opportunity of monitoring health-care utilization in a defined region for a well described population over time. Health-care insurance data are not affected by recall bias or social desirability bias, making subsequent analyses and conclusions very reliable and generalizable [8,9,10,11]
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