Cost-effectiveness of single family room care in a Canadian NICU: A randomized controlled trial

We save the lives of more preterm babies than ever before, but there have only been small improvements in how healthy these babies are after going home. Caring for these babies costs over half a billion dollars a year. Researchers in Sweden find that building hospitals where every family gets their own room helps babies go home sooner, and reduces their chances of developing serious lung disease. Other studies suggest that caring for babies in their own rooms might have a number of other benefits including improved breastfeeding, and reduced infections. Unfortunately, single rooms do not improve outcomes for every baby, and may actually result in harms to some. Researchers believe that benefits of single rooms come through increased parent presence and involvement in care; Parents in the original Swedish study spent 24 hours a day in the neonatal intensive care unit (NICU). We have little idea of what types of social and financial burdens are born by parents when units switch to single family room designs, and high visitation rates might not be feasible for all Canadians. Before encouraging changes in all of Canada's 177 NICUs we need to be sure that pursuing them does not create new disparities or make us miss opportunities that would make a bigger difference. This research will explore how much benefit is associated with a switch to single family room care, and at what cost to the healthcare system and parents. We will randomly assign families to either a single family room or open bay bed, and track how babies do in both types of rooms. We will also calculate costs incurred by the hospital and parents. Ours will be the first study to provide high quality evidence for what a switch to single family room designs means for the healthcare system and parents. Results will be able to be used by health leaders to help make decisions about whether they should make a switch, and what sorts of family and hospital factors they should consider.