The unforeseen toll of birth defects and their economic burden at a tertiary care public institute in Mumbai.
OBJECTIVE
To determine the proportion of patients with birth defects receiving indoor medical care and the economic burden incurred by the Institution in terms of cost of hospitalization.


METHODS
This single center, prospective, observational study recruited children>28 d and <12 y of age with birth defect(s) not attributable to an acquired disease. Demographic data, maternal and antenatal data, nature of the defect and information about current and past hospitalization were recorded. Economic burden was estimated by computing bed charges and daily costs incurred by the Institution.


RESULTS
Ninety-eight children (mean age was 3.18 y, M : F ratio was 2.4:1) with 268 birth defects represented 13% of indoor admissions. The cardiovascular system was involved in 42.9%. The defect was isolated in 58.2% of cases and 41.8% (9.2% having Down syndrome) had multiple defects. Mean duration of hospital stay (11.23 d) of the birth defect cohort was significantly more (p value=0.0005) than other children (7.81 d). Average cost of stay for those with birth defects (18.3% of the total cost) and other indoor patients was INR 23,481 and INR 16,328 respectively.


CONCLUSIONS
Birth defects are an emerging burden in referral centers, incurring one-fifth of the hospital expenditure, partly due to increased length of stay. The figure is an underestimate as the expenses are highly subsidized in a Public health facility.
The Genetic Clinic, Department of Pediatrics, Seth GS Medical College & KEM Hospital, Parel, Mumbai, India, muranjanmamta@gmail.com.
Mamta
M
Muranjan
P
P
Vijayalakshmi
D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000191:economics* / Q000453:epidemiology*; D017281:Cost of Illness; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D063128:Tertiary Health Care