Costs of neonatal care for low-birthweight babies in English hospitals.
OBJECTIVE
To estimate mean costs of neonatal care for babies with birthweights <or=1800 g in a regional Level 3 unit and three Level 2 units providing short-term intensive care.


METHODS
Babies <or=1800 g admitted to units in four hospitals in England over 15 months in 2001-2002 were audited until discharge. Unit costs (2005-2006 prices) were attributed to their resource items, including neonatal cot occupancy, pharmaceuticals, blood products and ambulance transfers. Bootstrapped mean costs were derived for the Level 3 unit and the Level 2 units combined.


RESULTS
The mean gestation period for 199 Level 3 babies was 29.5 weeks compared with 30.4 weeks for 192 Level 2 babies (p = 0.003). Mean costs excluding ambulance journeys were pound17,861 per Level 3 baby and pound12,344 per Level 2 baby. Level 3 babies <1000 g averaged pound26,815, whereas Level 2 babies <1000 g were generally less costly than babies 1000-1499 g. Ambulances transported 76 Level 3 babies and 62 Level 2 babies; their adjusted mean costs were pound18,495 and pound12,881, respectively.


CONCLUSIONS
By comprehensively costing resource components, the magnitude of total costs for low-birthweight babies has been revealed, thus demonstrating the importance of budgets for neonatal units being realistically determined by commissioners of neonatal services.
Health Economics Research Group, Brunel University, Uxbridge, Middlesex, UK. hema.mistry@brunel.ac.uk
Hema
H
Mistry
Robin
R
Dowie
Rodney C G
RC
Franklin
Bhavdeep R
BR
Jani
D000552:Ambulances / Q000191:economics; D001509:Bed Occupancy; D016001:Confidence Intervals; D004469:Economics, Hospital / Q000706:statistics & numerical data*; D004739:England; D005260:Female; D005865:Gestational Age; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000191:economics* / Q000706:statistics & numerical data; D015931:Intensive Care, Neonatal / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D008297:Male; D010343:Patient Admission; D010360:Patient Transfer / Q000191:economics; D011446:Prospective Studies; D012041:Regional Medical Programs / Q000191:economics*