title: Post-neonatal hospitalization and health care costs among IVF children: a 7-year follow-up study.
abstract: BACKGROUND
  The objective of this study was to evaluate whether the post-neonatal hospitalization and resulting health care costs are increased among in vitro fertilization (IVF) children up to 7 years of age.
  
  
  METHODS
  We conducted a population-based cohort study with linkage to a national hospital discharge register including 303 IVF children, born from 1990 to 1995, and 567 control children (1:2) randomly chosen from the Finnish Medical Birth Register and matched for sex, year of birth, area of residence, parity, maternal age and socioeconomic status. The cost calculations were stratified for singleton (n = 152 vs. n = 285) and twin (n = 103 vs. n = 103) status. Main outcome measures were hospitalizations and societal health care costs.
  
  
  RESULTS
  The full-sample and singleton analyses showed that IVF children were significantly more frequently admitted to hospital (mean 1.76 vs. 1.07, P < 0.0001; 1.61 vs. 1.07, P = 0.0004, respectively) and spent significantly more days in the hospital (mean 4.31 vs. 2.61, P < 0.0001; 3.47 vs. 2.56, P = 0.0014, respectively) than control children. No differences were detected between IVF and control twins. The costs of post-neonatal hospital care per child were 2.6-fold for IVF singletons, but 0.7-fold for IVF twins when compared with controls. Cost estimation showed 2.6-fold costs for total IVF population in comparison to general population based controls.
  
  
  CONCLUSIONS
  The incidence of multiple births increases the utilization of post-neonatal health care services and costs among IVF children in comparison to naturally conceived children. Increased hospitalization and costs were also seen among IVF singletons.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Oulu, 90029 Oulu, Finland. sari.koivurova@oulu.fi
authors.forename: Sari
authors.initials: S
authors.lastname: Koivurova
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Hartikainen
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Elina
authors.initials: E
authors.lastname: Hemminki
authors.forename: Marjo-Riitta
authors.initials: MR
authors.lastname: Järvelin
mesh_terms: D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D005307:Fertilization in Vitro; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male