title: Impact of very preterm birth on health care costs at five years of age.
abstract: OBJECTIVE
  We assessed the effects of very preterm birth (gestational age <32 weeks or birth weight <1501 g) and prematurity-related morbidities on health care costs during the fifth year of life.
  
  
  METHODS
  The study population consisted of 588 very preterm children and 176 term control subjects born in 2001-2002. Costs of hospitalizations, visits to health care professionals and therapists, and the use of other social welfare services were assessed during the fifth year of life. Hospital visits were derived from register data and other health care contacts, and the use of social welfare services were derived from parental reports. The effects of 6 prematurity-related morbidities (cerebral palsy [CP], seizure disorder, obstructive airway disease, hearing loss, visual disturbances or blindness, and other ophthalmologic problems) on the costs of health care were studied.
  
  
  RESULTS
  The average health care costs during the fifth year of life were 749 euro in the term control subjects, 1023 euro in the very preterm children without morbidities, and 3265 euro in those with morbidities. The costs of social welfare services and therapies exceeded the hospitalization costs in all groups. Among children who were born preterm, CP was associated with 5125 euro higher costs, whereas later obstructive airway diseases increased the costs by 819 euro compared with individuals without these morbidities.
  
  
  CONCLUSIONS
  The health care costs during the fifth year of life in very preterm children with morbidities were 4.4-fold and in those without morbidities 1.4-fold compared with those of term control subjects. This emphasizes the importance of prevention of morbidities, especially CP, to reduce the long-term costs of prematurity.
authors.affiliation: Turku University Hospital, Department of Pediatrics, Turku, Finland. emmi.korvenranta@utu.fi
authors.forename: Emmi
authors.initials: E
authors.lastname: Korvenranta
authors.forename: Liisa
authors.initials: L
authors.lastname: Lehtonen
authors.forename: Liisi
authors.initials: L
authors.lastname: Rautava
authors.forename: Unto
authors.initials: U
authors.lastname: Häkkinen
authors.forename: Sture
authors.initials: S
authors.lastname: Andersson
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Mikko
authors.initials: M
authors.lastname: Hallman
authors.forename: Jaana
authors.initials: J
authors.lastname: Leipälä
authors.forename: Mikko
authors.initials: M
authors.lastname: Peltola
authors.forename: Outi
authors.initials: O
authors.lastname: Tammela
authors.forename: Miika
authors.initials: M
authors.lastname: Linna
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D005865:Gestational Age; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000191:economics*; D019102:Infant, Very Low Birth Weight; D008297:Male; D009313:National Health Programs / Q000191:economics*; D010348:Patient Care Team / Q000191:economics; D012017:Referral and Consultation / Q000191:economics; D012946:Social Welfare / Q000191:economics