Costs of Neonatal Intensive Care for Canadian Infants with Preterm Birth

Canadian Preterm Birth Network Investigators; the Canadian Neonatal Network Investigators

doi:10.1016/j.jpeds.2020.09.045

Costs of Neonatal Intensive Care for Canadian Infants with Preterm Birth

Canadian Preterm Birth Network Investigators, the Canadian Neonatal Network Investigators

Medicine

Research output: Contribution to journal › Article › peer-review

25 Citations (Scopus)

Abstract

Objective: To develop and validate an itemized costing algorithm for in-patient neonatal intensive care unit (NICU) costs for infants born prematurely that can be used for quality improvement and health economic analyses. Study design: We sourced patient resource use data from the Canadian Neonatal Network database, with records from infants admitted to 30 tertiary NICUs in Canada. We sourced unit cost inputs from Ontario hospitals, schedules of benefits, and administrative sources. Costing estimates were generated by matching patient resource use data to the appropriate unit costs. All cost estimates were in 2017 Canadian dollars and assigned from the perspective of a provincial public payer. Results were validated using previous estimates of inpatient NICU costs and hospital case-cost estimates. Results: We assigned costs to 27 742 infants born prematurely admitted from 2015 to 2017. Mean (SD) gestational age and birth weight of the cohort were 31.8 (3.5) weeks and 1843 (739) g, respectively. The median (IQR) cost of hospitalization before NICU discharge was estimated as $20 184 ($9739-51 314) for all infants; $11 810 ($6410-19 800) for infants born at gestational age of 33-36 weeks; $30 572 ($16 597-$51 857) at gestational age of 29-32 weeks; and $100 440 ($56 858-$159 3867) at gestational age of <29 weeks. Cost estimates correlated with length of stay (r = 0.97) and gestational age (r = −0.65). The estimates were consistent with provincial resource estimates and previous estimates from Canada. Conclusions: NICU costs for infants with preterm birth increase as gestation decreases and length of stay increases. Our cost estimates are easily accessible, transparent, and congruent with previous cost estimates.

Original language	English
Pages (from-to)	161-167.e12
Journal	Journal of Pediatrics
Volume	229
DOIs	https://doi.org/10.1016/j.jpeds.2020.09.045
Publication status	Published - Feb 2021

Bibliographical note

Funding Information:
We thank all site investigators and abstractors of the Canadian Neonatal Network (CNN) and the Canadian Preterm Birth Network Investigators ( Appendix ). We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, Ontario, for organizational support of CNN. In addition, we thank Heather McDonald Kinkaid, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals.

Funding Information:
We thank all site investigators and abstractors of the Canadian Neonatal Network (CNN) and the Canadian Preterm Birth Network Investigators (Appendix). We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, Ontario, for organizational support of CNN. In addition, we thank Heather McDonald Kinkaid, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. Funding and disclosure information is available at www.jpeds.com.

Funding Information:
The Canadian Preterm Birth Network is supported by the Canadian Institutes of Health Research (CIHR) (Team Grant PBN150642). P.S. holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Although no specific funding was received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, ON, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors declare no conflicts of interest.

Publisher Copyright:
© 2020 Elsevier Inc.

ASJC Scopus Subject Areas

Pediatrics, Perinatology, and Child Health

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Access to Document

10.1016/j.jpeds.2020.09.045

Cite this

@article{da59c1f172614bc5897f1d6d0d1f1c7f,

title = "Costs of Neonatal Intensive Care for Canadian Infants with Preterm Birth",

abstract = "Objective: To develop and validate an itemized costing algorithm for in-patient neonatal intensive care unit (NICU) costs for infants born prematurely that can be used for quality improvement and health economic analyses. Study design: We sourced patient resource use data from the Canadian Neonatal Network database, with records from infants admitted to 30 tertiary NICUs in Canada. We sourced unit cost inputs from Ontario hospitals, schedules of benefits, and administrative sources. Costing estimates were generated by matching patient resource use data to the appropriate unit costs. All cost estimates were in 2017 Canadian dollars and assigned from the perspective of a provincial public payer. Results were validated using previous estimates of inpatient NICU costs and hospital case-cost estimates. Results: We assigned costs to 27 742 infants born prematurely admitted from 2015 to 2017. Mean (SD) gestational age and birth weight of the cohort were 31.8 (3.5) weeks and 1843 (739) g, respectively. The median (IQR) cost of hospitalization before NICU discharge was estimated as $20 184 ($9739-51 314) for all infants; $11 810 ($6410-19 800) for infants born at gestational age of 33-36 weeks; $30 572 ($16 597-$51 857) at gestational age of 29-32 weeks; and $100 440 ($56 858-$159 3867) at gestational age of <29 weeks. Cost estimates correlated with length of stay (r = 0.97) and gestational age (r = −0.65). The estimates were consistent with provincial resource estimates and previous estimates from Canada. Conclusions: NICU costs for infants with preterm birth increase as gestation decreases and length of stay increases. Our cost estimates are easily accessible, transparent, and congruent with previous cost estimates.",

author = "{Canadian Preterm Birth Network Investigators} and {the Canadian Neonatal Network Investigators} and Rios, {Juan D.} and Shah, {Prakesh S.} and Marc Beltempo and Deepak Louis and Amit Mukerji and Shahirose Premji and Vibhuti Shah and Lee, {Shoo K.} and Petros Pechlivanoglou and Haim Abenhaim and Jehier Afifi and Ruben Alvaro and James Andrews and Anthony Armson and Francois Audibert and Khalid Aziz and Marilyn Ballantyne and Jon Barrett and Anick Berard and Valerie Bertelle and Lucie Blais and Alan Bocking and Jaya Bodani and Jason Burrows and Kimberly Butt and Roderick Canning and George Carson and Nils Chaillet and Sue Chandra and Paige Church and Zenon Cieslak and Joan Crane and Dianne Creighton and {Da Silva}, Orlando and Thierry Daboval and Leanne Dahlgren and Sibasis Daspal and {de Cabo}, Cecilia and Akhil Deshpandey and Kimberly Dow and Christine Drolet and Michael Dunn and {Salhab el Helou}, {el Helou} and Darine El-Chaar and Walid El-Naggar and Carlos Fajardo and Robert Gagnon and Rob Gratton and Victor Han and Adele Harrison",

note = "Funding Information: We thank all site investigators and abstractors of the Canadian Neonatal Network (CNN) and the Canadian Preterm Birth Network Investigators ( Appendix ). We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, Ontario, for organizational support of CNN. In addition, we thank Heather McDonald Kinkaid, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. Funding Information: We thank all site investigators and abstractors of the Canadian Neonatal Network (CNN) and the Canadian Preterm Birth Network Investigators (Appendix). We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, Ontario, for organizational support of CNN. In addition, we thank Heather McDonald Kinkaid, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. Funding and disclosure information is available at www.jpeds.com. Funding Information: The Canadian Preterm Birth Network is supported by the Canadian Institutes of Health Research (CIHR) (Team Grant PBN150642). P.S. holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Although no specific funding was received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, ON, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

year = "2021",

month = feb,

doi = "10.1016/j.jpeds.2020.09.045",

language = "English",

volume = "229",

pages = "161--167.e12",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Costs of Neonatal Intensive Care for Canadian Infants with Preterm Birth

AU - Canadian Preterm Birth Network Investigators

AU - the Canadian Neonatal Network Investigators

AU - Rios, Juan D.

AU - Shah, Prakesh S.

AU - Beltempo, Marc

AU - Louis, Deepak

AU - Mukerji, Amit

AU - Premji, Shahirose

AU - Shah, Vibhuti

AU - Lee, Shoo K.

AU - Pechlivanoglou, Petros

AU - Abenhaim, Haim

AU - Afifi, Jehier

AU - Alvaro, Ruben

AU - Andrews, James

AU - Armson, Anthony

AU - Audibert, Francois

AU - Aziz, Khalid

AU - Ballantyne, Marilyn

AU - Barrett, Jon

AU - Berard, Anick

AU - Bertelle, Valerie

AU - Blais, Lucie

AU - Bocking, Alan

AU - Bodani, Jaya

AU - Burrows, Jason

AU - Butt, Kimberly

AU - Canning, Roderick

AU - Carson, George

AU - Chaillet, Nils

AU - Chandra, Sue

AU - Church, Paige

AU - Cieslak, Zenon

AU - Crane, Joan

AU - Creighton, Dianne

AU - Da Silva, Orlando

AU - Daboval, Thierry

AU - Dahlgren, Leanne

AU - Daspal, Sibasis

AU - de Cabo, Cecilia

AU - Deshpandey, Akhil

AU - Dow, Kimberly

AU - Drolet, Christine

AU - Dunn, Michael

AU - Salhab el Helou, el Helou

AU - El-Chaar, Darine

AU - El-Naggar, Walid

AU - Fajardo, Carlos

AU - Gagnon, Robert

AU - Gratton, Rob

AU - Han, Victor

AU - Harrison, Adele

N1 - Funding Information: We thank all site investigators and abstractors of the Canadian Neonatal Network (CNN) and the Canadian Preterm Birth Network Investigators ( Appendix ). We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, Ontario, for organizational support of CNN. In addition, we thank Heather McDonald Kinkaid, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. Funding Information: We thank all site investigators and abstractors of the Canadian Neonatal Network (CNN) and the Canadian Preterm Birth Network Investigators (Appendix). We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, Ontario, for organizational support of CNN. In addition, we thank Heather McDonald Kinkaid, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. Funding and disclosure information is available at www.jpeds.com. Funding Information: The Canadian Preterm Birth Network is supported by the Canadian Institutes of Health Research (CIHR) (Team Grant PBN150642). P.S. holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Although no specific funding was received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, ON, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors declare no conflicts of interest. Publisher Copyright: © 2020 Elsevier Inc.

PY - 2021/2

Y1 - 2021/2

N2 - Objective: To develop and validate an itemized costing algorithm for in-patient neonatal intensive care unit (NICU) costs for infants born prematurely that can be used for quality improvement and health economic analyses. Study design: We sourced patient resource use data from the Canadian Neonatal Network database, with records from infants admitted to 30 tertiary NICUs in Canada. We sourced unit cost inputs from Ontario hospitals, schedules of benefits, and administrative sources. Costing estimates were generated by matching patient resource use data to the appropriate unit costs. All cost estimates were in 2017 Canadian dollars and assigned from the perspective of a provincial public payer. Results were validated using previous estimates of inpatient NICU costs and hospital case-cost estimates. Results: We assigned costs to 27 742 infants born prematurely admitted from 2015 to 2017. Mean (SD) gestational age and birth weight of the cohort were 31.8 (3.5) weeks and 1843 (739) g, respectively. The median (IQR) cost of hospitalization before NICU discharge was estimated as $20 184 ($9739-51 314) for all infants; $11 810 ($6410-19 800) for infants born at gestational age of 33-36 weeks; $30 572 ($16 597-$51 857) at gestational age of 29-32 weeks; and $100 440 ($56 858-$159 3867) at gestational age of <29 weeks. Cost estimates correlated with length of stay (r = 0.97) and gestational age (r = −0.65). The estimates were consistent with provincial resource estimates and previous estimates from Canada. Conclusions: NICU costs for infants with preterm birth increase as gestation decreases and length of stay increases. Our cost estimates are easily accessible, transparent, and congruent with previous cost estimates.

AB - Objective: To develop and validate an itemized costing algorithm for in-patient neonatal intensive care unit (NICU) costs for infants born prematurely that can be used for quality improvement and health economic analyses. Study design: We sourced patient resource use data from the Canadian Neonatal Network database, with records from infants admitted to 30 tertiary NICUs in Canada. We sourced unit cost inputs from Ontario hospitals, schedules of benefits, and administrative sources. Costing estimates were generated by matching patient resource use data to the appropriate unit costs. All cost estimates were in 2017 Canadian dollars and assigned from the perspective of a provincial public payer. Results were validated using previous estimates of inpatient NICU costs and hospital case-cost estimates. Results: We assigned costs to 27 742 infants born prematurely admitted from 2015 to 2017. Mean (SD) gestational age and birth weight of the cohort were 31.8 (3.5) weeks and 1843 (739) g, respectively. The median (IQR) cost of hospitalization before NICU discharge was estimated as $20 184 ($9739-51 314) for all infants; $11 810 ($6410-19 800) for infants born at gestational age of 33-36 weeks; $30 572 ($16 597-$51 857) at gestational age of 29-32 weeks; and $100 440 ($56 858-$159 3867) at gestational age of <29 weeks. Cost estimates correlated with length of stay (r = 0.97) and gestational age (r = −0.65). The estimates were consistent with provincial resource estimates and previous estimates from Canada. Conclusions: NICU costs for infants with preterm birth increase as gestation decreases and length of stay increases. Our cost estimates are easily accessible, transparent, and congruent with previous cost estimates.

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UR - http://www.scopus.com/inward/citedby.url?scp=85095606109&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2020.09.045

DO - 10.1016/j.jpeds.2020.09.045

M3 - Article

C2 - 32979384

AN - SCOPUS:85095606109

SN - 0022-3476

VL - 229

SP - 161-167.e12

JO - Journal of Pediatrics

JF - Journal of Pediatrics

ER -

Costs of Neonatal Intensive Care for Canadian Infants with Preterm Birth

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

Access to Document

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