Variations in costs for the care of low-birth-weight infants among academic hospitals.
OBJECTIVE
To determine the relative role that academic hospitals (AHs) play in providing neonatal care for low-birth-weight infants within a single state and to determine if there are variations in inpatient costs for neonatal services among AHs.


METHODS
Retrospective analysis of hospital costs for low-birth-weight infants.


METHODS
Cases were identified using 2003-2005 data from the Tennessee Hospital Discharge Data System. A specific focus was discharge data from the 5 AHs that support obstetrical residencies and have a neonatal intensive care unit.


METHODS
Cases included all discharged infants with a birth weight of <2500 grams.


RESULTS
The 5 AHs discharged 18% of the total normal-birth-weight infants and 30% of the low-birth-weight infants for the entire state. AHs had higher costs associated with these infants than did other hospitals, with a single exception The difference in costs at this hospital was consistent with the finding of lower utilization rates of hospital services, a shorter average length of stay, and lower costs for infants insured by the state Medicaid program.


CONCLUSIONS
Academic obstetrical hospitals discharged a disproportionately high percentage of low-birth-weight infants compared with other Tennessee hospitals. The lower costs observed in the Shelby County hospital indicates that other hospitals could potentially lower their costs for the care of low-birth-weight infants.
Herrod
Henry G
HG
Department of Pediatrics, the University of Tennessee Health Science Center and The Urban Child Institute, Memphis, TN 38105, USA. hherrod@theurbanchildinstitute.org
Chang
Cyril F
CF
Steinberg
Stephanie S
SS
D000046:Academic Medical Centers / Q000191:economics*; D001724:Birth Weight; D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics* / Q000379:methods; D016208:Databases, Factual; D005260:Female; D005865:Gestational Age; D017721:Hospital Costs; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007224:Infant Care / Q000191:economics*; D007226:Infant Mortality / Q000639:trends; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D008297:Male; D011247:Pregnancy; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States