title: Economic implications of multiple births: inpatient hospital costs in the first 5 years of life.
abstract: OBJECTIVE
  To estimate long term health service costs for hospital stays associated with singleton, twin, and higher order multiple births up to 5 years of age.
  
  
  METHODS
  Costs from specialty based data from the English Department of Health's NHS Trust Financial Returns were applied to admissions recorded in the Oxford record linkage study during 1970-1993.
  
  
  METHODS
  Oxfordshire and West Berkshire, United Kingdom.
  
  
  METHODS
  A total of 276,897 children, of whom 270,428 were singletons, 6284 were twins, and 185 were higher order multiple births.
  
  
  METHODS
  Duration of hospital admissions during the first 5 years of life. Costs, expressed in pound sterling and valued at 1998-1999 prices, of hospital inpatient services.
  
  
  RESULTS
  The total duration of hospital admissions for twins and triplets were respectively twice and eight times that for singletons, once duration of life had been taken into account. Inpatient costs were significantly higher for multiple births than for singletons, with the cost differences concentrated in the first year of life. Over the first 5 years of life, the adjusted mean cost was estimated at 1532 pounds (95% confidence interval (CI) 1516 pounds to 1548 pounds) for singletons, 3826 pounds (95%CI 3724 pounds to 3929 pounds) for twins, and 8156 pounds (95%CI 7559 pounds to 8754 pounds) for higher order multiple births (p < 0.0001).
  
  
  CONCLUSIONS
  Multiple births contribute disproportionately to hospital inpatient costs, especially during the children's first year of life.
authors.affiliation: National Perinatal Epidemiology Unit, Old Road Campus, University of Oxford, Old Road, Headington, Oxford OX3 7LF, UK. jane.henderson@perinat.ox.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Henderson
authors.forename: C
authors.initials: C
authors.lastname: Hockley
authors.forename: S
authors.initials: S
authors.lastname: Petrou
authors.forename: M
authors.initials: M
authors.lastname: Goldacre
authors.forename: L
authors.initials: L
authors.lastname: Davidson
mesh_terms: D000367:Age Factors; D002654:Child Care / Q000191:economics*; D002675:Child, Preschool; D004739:England; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000191:economics*; D007226:Infant Mortality; D007231:Infant, Newborn; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D009017:Morbidity; D009099:Multiple Birth Offspring; D012307:Risk Factors; D013222:State Medicine / Q000191:economics; D016019:Survival Analysis; D014310:Triplets; D014427:Twins