Outcomes and resource utilization for newborns with major congenital malformations: the initial NICU admission.

Abstract

Newborns with major congenital malformations (MCM) have contributed to a significant proportion of resource utilization in a regional referral neonatal intensive care unit (NICU). The Children's Hospital Medical Center NICU, Cincinnati, OH. Newborns with and without MCM admitted from August 1, 1993 through July 31, 1994. Total patients studied were 572; 147 with and 385 without MCM. No intervention was performed in this observational study. Statistics were t test, chi-squared, and rank sum analysis. MCM accounted for 27.6% of NICU referrals, 32.4% of total NICU days, and 39.6% of NICU costs. Both median cost per patient and length of stay were significantly (p < 0.01) higher for patients with MCM than those without MCM. Surgery was more frequent in MCM than non-MCM cases. Thirty-three percent of the newborns with MCM received ongoing medical support at discharge. Patients with MCM remain as one of the largest and costliest groups hospitalized in a referral NICU.