A1 Refereed original research article in a scientific journal
Hospital Costs and Quality of Life During 4 Years After Very Preterm Birth
Authors: Korvenranta E, Linna M, Rautava L, Andersson S, Gissler M, Hallman M, Hakkinen U, Leipala J, Peltola M, Tammela O, Lehtonen L
Publisher: AMER MEDICAL ASSOC
Publication year: 2010
Journal: Archives of Pediatrics and Adolescent Medicine
Journal name in source: ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE
Journal acronym: ARCH PEDIAT ADOL MED
Volume: 164
Issue: 7
First page : 657
Last page: 663
Number of pages: 7
ISSN: 1072-4710
DOI: https://doi.org/10.1001/archpediatrics.2010.99
Abstract
Objective: To evaluate the effect of gestational age and prematurity-related morbidities on hospital costs and cost per quality-adjusted life-year (QALY) during the first 4 years of life.Design: Population-based study using national register data and parental questionnaires.Setting: Finland.Participants: All 2064 very preterm children (gestational age <32 weeks or birth weight <1501 g) and all 200 609 full-term control individuals (mean [SD] gestational age, 37 [0] to 41 [6] weeks) born from January 1, 2000, through December 31, 2003.Main Exposure: Prematurity.Main Outcome Measures: Costs of hospital care and cost per QALY at 4 years of age according to gestational age and prematurity-related morbidities.Results: By 4 years of age, the cost per QALY for fullterm controls (in 2008 currency) was 1181 (US$1736). In very preterm children, the average cost per QALY was 19 245 ($28290), ranging from 11 824 to 54 324 ($17 381 to $79 856) and increasing with decreasing gestational age. The cost per QALY was 14 368 ($21 121) for those without any of the studied morbidities and 36 110 ($53 082) for those with 2 or more morbidities. The costs of the initial hospital stay comprised 79.5% of the total 4-year hospital costs in very preterm children.Conclusions: We conclude that the cost per QALY in this patient group is at an acceptable level by 4 years of age. Because the initial hospital care episode accounted for most of the costs, the cost per QALY will decrease with each additional follow-up year.
Objective: To evaluate the effect of gestational age and prematurity-related morbidities on hospital costs and cost per quality-adjusted life-year (QALY) during the first 4 years of life.Design: Population-based study using national register data and parental questionnaires.Setting: Finland.Participants: All 2064 very preterm children (gestational age <32 weeks or birth weight <1501 g) and all 200 609 full-term control individuals (mean [SD] gestational age, 37 [0] to 41 [6] weeks) born from January 1, 2000, through December 31, 2003.Main Exposure: Prematurity.Main Outcome Measures: Costs of hospital care and cost per QALY at 4 years of age according to gestational age and prematurity-related morbidities.Results: By 4 years of age, the cost per QALY for fullterm controls (in 2008 currency) was 1181 (US$1736). In very preterm children, the average cost per QALY was 19 245 ($28290), ranging from 11 824 to 54 324 ($17 381 to $79 856) and increasing with decreasing gestational age. The cost per QALY was 14 368 ($21 121) for those without any of the studied morbidities and 36 110 ($53 082) for those with 2 or more morbidities. The costs of the initial hospital stay comprised 79.5% of the total 4-year hospital costs in very preterm children.Conclusions: We conclude that the cost per QALY in this patient group is at an acceptable level by 4 years of age. Because the initial hospital care episode accounted for most of the costs, the cost per QALY will decrease with each additional follow-up year.
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