[Cost benefit analysis of care of low-birth-weight infants].
A model for cost-benefit analysis of medical care of low-birth-weight infants was proposed in order to evaluate its economic efficiency using the notion of an expected value, routinely used in economics. The expected cost and benefit when a low-birth-weight infant is born were calculated and compared. Cost includes the hospital charges and the charges for long-term care of a handicapped survivor. Benefit includes the present value of lifetime earnings. Benefit/Cost Ratio was selected as a criterion to determine efficiency, with values exceeding 1 representing the case where the expected benefit exceeds the expected cost, meaning a net economic gain. Actual values were substituted in the model for cost-benefit analysis of care of very-low-birth-weight infants. Benefit/Cost Ratios corresponding to various birth weights were calculated, and the break-even point was found to be about 800 g, which was consistent with several former reports. However sensitivity analysis indicated that Benefit/Cost Ratio was affected greatly when either the discount rate or charges for long-term care of a handicapped survivor was changed. A net economic loss would be attributable to the higher incidence of sequela corresponding to very-low-birth-weight, which would suggest that to enhance economic gain investment in care for increasing the rate of intact survivals is essential. Further study is required to define adequate values, and to determine the grade of handicap as well as lifetime earnings.
Department of Preventive Medicine and Public Health, School of Medicine, Keio University.
K
K
Shirasaya
N
N
Shimada
T
T
Uemura
S
S
Ikeda
M
M
Miyakawa
T
T
Kondo
D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn