Health care utilization by preterm infants with respiratory complications in Quebec.
BACKGROUND
Despite notable advances in prenatal and neonatal care, respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) remain important complications of preterm births, and their long-term sequelae are poorly understood.


OBJECTIVE
To describe health care utilization and costs over a 16- to 25-year follow-up period in a cohort of preterm infants with respiratory complications.


METHODS
Using provincial health administrative databases from Quebec, a cohort of individuals who were born prematurely with complications of RDS and⁄or BPD between 1983 and 1992 were identified. From these databases, which cover all Quebec residents, health services use, medication prescriptions, associated diagnoses and costs were tabulated.


RESULTS
A total of 3442 subjects with respiratory complications following preterm birth were identified, of whom 773 had been diagnosed with BPD and 2669 had RDS without BPD. Asthma was diagnosed twice as frequently (1.7 to 2.4 times) in the BPD group compared with the RDS group, with more frequent hospital readmission, and outpatient and emergency room visits. Although respiratory causes remained the main reason for consultation in both groups, 3.7% and 3.4% of the outpatient visits were for mental or psychological ailments, such as depression, attention deficit hyperactivity disorder or dysthymia for the BPD and RDS groups, respectively.


CONCLUSIONS
BPD patients experienced more hospital admissions, outpatient and emergency rooms visits, and were more likely to suffer from respiratory illnesses and to use respiratory drugs than RDS patients. Neurological and psychiatric complications occurred at a high frequency in both RDS and BPD subjects, and were associated with significant use of antipsychotic and antidepressant medications.
Respiratory Epidemiology and Clinicial Research Unit, McGill University, Montreal, Quebec. jennifer.landry@mcgill.ca
Jennifer Sophie
JS
Landry
Dan
D
Croitoru
Yulan
Y
Jin
Kevin
K
Schwartzman
Andrea
A
Benedetti
Dick
D
Menzies
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D015331:Cohort Studies; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D009422:Nervous System Diseases / Q000453:epidemiology; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data; D011792:Quebec / Q000453:epidemiology; D012120:Respiration Disorders / Q000453:epidemiology*; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D055815:Young Adult