Ciaran S Phibbs1, Susan K Schmitt2, Matthew Cooper3, Jeffrey B Gould4, Henry C Lee4, Jochen Profit4, Scott A Lorch5. 1. Health Economics Resource Center and Center for Implementation to Innovation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA; Perinatal Epidemiology and Health Outcomes Research Unit, Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, CA. Electronic address: cphibbs@stanford.edu. 2. Health Economics Resource Center and Center for Implementation to Innovation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA; Perinatal Epidemiology and Health Outcomes Research Unit, Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, CA. 3. Progenity, Inc., San Diego, CA; Preeclampsia Foundation, Melbourne, FL. 4. Perinatal Epidemiology and Health Outcomes Research Unit, Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, CA; California Perinatal Quality Care Collaborative, Palo Alto, CA. 5. Center for Outcomes Research, Children's Hospital of Philadelphia, Philadelphia, PA; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, Philadelphia, PA.
Abstract
OBJECTIVE: To provide population-based estimates of the hospital-related costs of maternal and newborn care, and how these vary by gestational age and birth weight. STUDY DESIGN: We conducted a retrospective analysis of 2009-2011 California in-hospital deliveries at nonfederal hospitals with the infant and maternal discharge data successfully (96%) linked to birth certificates. Cost-to-charge ratios were used to estimate costs from charges. Physician hospital payments were estimated by mean diagnosis related group-specific reimbursement and costs were adjusted for inflation to December 2017 values. After exclusions for incomplete or missing data, the final sample was 1 265 212. RESULTS: The mean maternal costs for all in-hospital deliveries was $8204, increasing to $13 154 for late preterm (32-36 weeks) and $22 702 for very preterm (<32 weeks) mothers. The mean cost for all newborns was $6389: $2433 for term infants, $22 102 for late preterm, $223 931 for very preterm infants, and $317 982 for extremely preterm infants (<28 weeks). Preterm infants were 8.1% of cases but incurred 60.9% of costs; for very preterm and extremely preterm infants, these shares were 1.0% and 36.5%, and 0.4% and 20.0%, respectively. Overall, mothers incurred 56% of the total costs during the delivery hospitalization. CONCLUSIONS: Both maternal and neonatal costs are skewed, with this being much more pronounced for infants. Preterm birth is much more expensive than term delivery, with the additional costs predominately incurred by the infants. The small share of infants who require extensive stays in neonatal intensive care incur a large share of neonatal costs and these costs have increased over time.
OBJECTIVE: To provide population-based estimates of the hospital-related costs of maternal and newborn care, and how these vary by gestational age and birth weight. STUDY DESIGN: We conducted a retrospective analysis of 2009-2011 California in-hospital deliveries at nonfederal hospitals with the infant and maternal discharge data successfully (96%) linked to birth certificates. Cost-to-charge ratios were used to estimate costs from charges. Physician hospital payments were estimated by mean diagnosis related group-specific reimbursement and costs were adjusted for inflation to December 2017 values. After exclusions for incomplete or missing data, the final sample was 1 265 212. RESULTS: The mean maternal costs for all in-hospital deliveries was $8204, increasing to $13 154 for late preterm (32-36 weeks) and $22 702 for very preterm (<32 weeks) mothers. The mean cost for all newborns was $6389: $2433 for term infants, $22 102 for late preterm, $223 931 for very preterm infants, and $317 982 for extremely preterm infants (<28 weeks). Preterm infants were 8.1% of cases but incurred 60.9% of costs; for very preterm and extremely preterm infants, these shares were 1.0% and 36.5%, and 0.4% and 20.0%, respectively. Overall, mothers incurred 56% of the total costs during the delivery hospitalization. CONCLUSIONS: Both maternal and neonatal costs are skewed, with this being much more pronounced for infants. Preterm birth is much more expensive than term delivery, with the additional costs predominately incurred by the infants. The small share of infants who require extensive stays in neonatal intensive care incur a large share of neonatal costs and these costs have increased over time.
Authors: Jeffrey D Horbar; Gary J Badger; Joseph H Carpenter; Avroy A Fanaroff; Sarah Kilpatrick; Meena LaCorte; Roderic Phibbs; Roger F Soll Journal: Pediatrics Date: 2002-07 Impact factor: 7.124
Authors: Rebecca B Russell; Nancy S Green; Claudia A Steiner; Susan Meikle; Jennifer L Howse; Karalee Poschman; Todd Dias; Lisa Potetz; Michael J Davidoff; Karla Damus; Joann R Petrini Journal: Pediatrics Date: 2007-07 Impact factor: 7.124
Authors: Liona C Poon; Andrew Shennan; Jonathan A Hyett; Anil Kapur; Eran Hadar; Hema Divakar; Fionnuala McAuliffe; Fabricio da Silva Costa; Peter von Dadelszen; Harold David McIntyre; Anne B Kihara; Gian Carlo Di Renzo; Roberto Romero; Mary D'Alton; Vincenzo Berghella; Kypros H Nicolaides; Moshe Hod Journal: Int J Gynaecol Obstet Date: 2019-05 Impact factor: 3.561
Authors: Holly Elser; Alison Gemmill; Joan A Casey; Deborah Karasek; Tim Bruckner; Jonathan A Mayo; Henry C Lee; David K Stevenson; Gary M Shaw; Ralph Catalano Journal: Ann Epidemiol Date: 2020-07-08 Impact factor: 3.797
Authors: Alison Gemmill; Ralph Catalano; Héctor Alcalá; Deborah Karasek; Joan A Casey; Tim A Bruckner Journal: Early Hum Dev Date: 2020-10-03 Impact factor: 2.079
Authors: Cynthia Gyamfi-Bannerman; John A F Zupancic; Grecio Sandoval; William A Grobman; Sean C Blackwell; Alan T N Tita; Uma M Reddy; Lucky Jain; George R Saade; Dwight J Rouse; Jay D Iams; Erin A S Clark; John M Thorp; Edward K Chien; Alan M Peaceman; Ronald S Gibbs; Geeta K Swamy; Mary E Norton; Brian M Casey; Steve N Caritis; Jorge E Tolosa; Yoram Sorokin; J Peter VanDorsten Journal: JAMA Pediatr Date: 2019-05-01 Impact factor: 16.193
Authors: Nansi S Boghossian; Marco Geraci; Scott A Lorch; Ciaran S Phibbs; Erika M Edwards; Jeffrey D Horbar Journal: Pediatrics Date: 2019-08-12 Impact factor: 7.124
Authors: Kristin Bergman; Nina E Forestieri; Vito L Di Bona; Scott D Grosse; Cynthia A Moore Journal: Birth Defects Res Date: 2022-01-04 Impact factor: 2.661