Abstract
Objective This study was aimed to compare health care costs and utilization at birth through
1 year, between preterm and term infants, by week of gestation.
Methods A cross-sectional study of infants born at ≥ 23 weeks of gestational age (GA) at
Kaiser Permanente Northern California facilities between 2000 and 2011, using outcomes
data from an internal neonatal registry and cost estimates from an internal cost management
database. Adjusted models yielded estimates for cost differences for each GA group.
Results Infants born at 25 to 37 weeks incur significantly higher birth hospitalization costs
and experience significantly more health care utilization during the initial year
of life, increasing progressively for each decreasing week of gestation, when compared
with term infants. Among all very preterm infants (≤ 32 weeks), each 1-week decrease
in GA is associated with incrementally higher rates of mortality and major morbidities.
Conclusion We provide estimates of potential cost savings that could be attributable to interventions
that delay or prevent preterm delivery. Cost differences were most extreme at the
lower range of gestation (≤ 30 weeks); however, infants born moderately preterm (31–36
weeks) also contribute substantially to the burden, as they represent a higher proportion
of total births.
Keywords
preterm birth - health care costs - utilization - neonatal intensive care
