Resource utilization associated with initial hospital stays complicated by early onset group B streptococcal disease.
BACKGROUND
The epidemiology of early onset neonatal group B streptococcal (GBS) disease has changed appreciably, but there are no recent assessments of the in-hospital resource utilization it incurs.


METHODS
We performed a retrospective cohort study of infants delivered from 1987 through 1995 at Massachusetts' largest obstetrics hospital. A matched cohort design was used to assess care occurring after transfer to another acute care hospital.


RESULTS
There were 135 cases of early onset neonatal GBS infection complicating 85,062 deliveries (1.6/1,000 births) in 9 years, with a substantial decline beginning in 1994, when maternal intrapartum chemoprophylaxis was widely introduced. Most (73%) infants had birth weights of 2500 g or more; 93% survived. Overall both the median and mean lengths of stay were 8 days longer for infants with GBS disease than for those without this infection (P < 0.001). Total hospital charges for neonates with GBS disease also were higher, with the difference in medians of $5323 and in means of $10,004 (P < 0.001). Differences were greatest among >2500-g birth weight infants; no excess was evident for infants with birth weights of < 1500 g.


CONCLUSIONS
There was a substantial excess length of stay and charges associated with early onset neonatal GBS disease, although this was less than previously reported.
Platt
R
R
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Adelson-Mitty
J
J
Weissman
L
L
Zaleznik
D
D
Lee
M L
ML
Baker
C J
CJ
D017281:Cost of Illness; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000191:economics* / Q000517:prevention & control; D007902:Length of Stay; D008404:Massachusetts; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy / Q000191:economics* / Q000517:prevention & control / Q000635:transmission; D013292:Streptococcus agalactiae