title: Clinical outcome and cost of treatment and care for neonates less than 1000 grams admitted to Vali-e ASR Hospital.
abstract: BACKGROUND
  The aim of this study is to estimate the cost of care and treatment for extremely low birth weight (ELBW) neonates admitted to a teaching and referral hospital. This cost estimation project can help health policy makers and planners make decisions and develop plans for perinatal service staging programs and better management of NICUs (Neonatal Intensive Care Units).
  
  
  METHODS
  This cohort study performed on 50 extremely low birth weight neonates (w ≤ 1000gr) born in Vali-e Asr Hospital, Tehran-Iran in the period of March 2012 to September 2013. This teaching and referral hospital had 15 NICU beds as well as an active neonatal growth and development follow-up clinic with a pediatric neurodevelopment specialist during the period of the study. Cases would undergo initial developmental visits and preventative measures immediately after being admitted to the ward. Also after discharge, they were followed up monthly for six months and then every two months, during first year of life.
  
  
  RESULTS
  Overalls, 23 newborns -46% of ELBW and 40% of total neonatal mortality rate (that amounted 55) died during hospital stay. Beside hospitalization, the major part of expenses was related to medication and medical supplies. All neonates needing rehabilitation underwent this type of intervention for one year. The mean cost of rehabilitation in neonates with no insurance coverage was 6700 US Dollars per year, which is reduced by half (3350 US Dollars) when covered by insurance.
  
  
  CONCLUSIONS
  Medication, medical supplies and equipment cost was significantly high. This is especially due to the fact that the present types of insurances do not cover such expenses very well, forcing parents to pay themselves. Insurance systems are expected to take this issue into immediate account.
authors.affiliation: Breastfeeding Research Center, University of Medical Sciences, Keshavarz blvd., Tehran 1419733141, Iran.
authors.forename: Hosein
authors.initials: H
authors.lastname: Dalili
authors.affiliation: Breastfeeding Research Center, Tehran University of Medical Sciences, Keshavarz blvd., Tehran 1419733141, Iran.
authors.forename: Mohaddese
authors.initials: M
authors.lastname: Fallahi
authors.affiliation: Maternal, Fetal & Neonatal Research Center, Tehran University of Medical Sciences, Keshavarz blvd., Tehran 1419733141, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Moradi
authors.affiliation: Breastfeeding Research Center - Maternal, Fetal & Neonatal Research Center, Tehran University of Medical Sciences, Keshavarz blvd., Tehran 1419733141, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Nayeri
authors.affiliation: Maternal, Fetal & Neonatal Research Center, Tehran University of Medical Sciences, Keshavarz blvd., Tehran 1419733141, Iran.
authors.forename: Mamak
authors.initials: M
authors.lastname: Shariat
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Keshavarz blvd., Tehran 1419733141, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Rashidian
keywords: Cost of treatment; ELBW neonates; Hospital expenses