Abstract
Background: The objective is to study previously unexplored trends of birth hospitalization and readmission costs for late preterm infants (LPIs) in the United States between 2005 and 2016. Methods: We conducted a retrospective analysis of claims data to study healthcare costs of birth hospitalization and readmissions for LPIs compared to term infants (TIs) using a large private insurance database. We used a generalized linear regression model to study birth hospitalization and readmission costs. Results: A total of 2,123,143 infants were examined (93.2% TIs; 6.8% LPIs). The proportion of LPIs requiring readmission was 4.2% compared to 2.1% of TIs, (p < 0.001). The readmission rate for TIs decreased during the study period. LPIs had a higher mean cost of birth hospitalization (25,700 vs. 3300 USD; p < 0.001) and readmissions (25,800 vs. 14,300 USD; p < 0.001). For LPIs, birth hospitalization costs increased from 2007 to 2013, and decreased since 2014. Conversely, birth hospitalization costs of TIs steadily increased since 2005. The West region showed higher birth hospitalization costs for LPIs. Conclusions: LPIs continue to have a higher cost of birth hospitalization and readmission compared to TIs, but these costs have decreased since 2014. Standardization of birth hospitalization care for LPIs may reduce costs and improve quality of care and outcomes.
Highlights
In 2005, the National Institute of Child Health and Human Development recommended replacing the phrase “near term” with “late preterm ” to distinguish infants born between 34 weeks and 0/7 days and 36 weeks and 6/7 days from term infants (TIs) (≥37 weeks), acknowledging the vulnerability of the late preterm infants (LPIs) and helping redirect research efforts [1]
After applying the continuous 30-day enrollment criterion, the final study cohort consisted of 2,123,143 infants with 145,201 (6.8%) classified as late preterm and 1,977,942 (93.2%) classified as term (Figure 1)
We continue to observe higher birth hospitalization costs, readmission rate and costs for LPIs compared to TIs
Summary
Prematurity is associated with increased short- and long-term readmission rates compared to TIs [2,5,7,18,19,20]. Despite efforts to ameliorate the costs [19], such as determining gestational age based appropriate length of stay (LOS), the upward trend of late premature births has created a heavy burden in terms of healthcare costs [18,19,21]. The objective is to study previously unexplored trends of birth hospitalization and readmission costs for late preterm infants (LPIs) in the United States between 2005 and 2016. Methods: We conducted a retrospective analysis of claims data to study healthcare costs of birth hospitalization and readmissions for LPIs compared to term infants (TIs) using a large private insurance database. Standardization of birth hospitalization care for LPIs may reduce costs and improve quality of care and outcomes
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