Ball T M, Wright A L
Department of Pediatrics and Steele Memorial Children's Research Center, University of Arizona, Tucson, USA.
Pediatrics. 1999 Apr;103(4 Pt 2):870-6.
To determine the excess cost of health care services for three illnesses in formula-fed infants in the first year of life, after adjusting for potential confounders.
Frequency of health service utilization for three illnesses (lower respiratory tract illnesses, otitis media, and gastrointestinal illness) in the first year of life was assessed in relation to duration of exclusive breastfeeding in the Tucson Children's Respiratory Study (n = 944) and the Dundee Community Study (Scottish study, n = 644). Infants in both studies were healthy at birth and represented nonselected, population-based samples. Children were classified as never breastfed, partially breastfed, or exclusively breastfed, based on their feeding status during the first 3 months of life. Frequency of office visits and hospitalizations for the three illnesses was adjusted for maternal education and maternal smoking, using analysis of variance. Cost estimates, from the perspective of the health care provider/payer, were based on the direct medical costs during 1995 within a large managed care health care system.
In the first year of life, after adjusting for confounders, there were 2033 excess office visits, 212 excess days of hospitalization, and 609 excess prescriptions for these three illnesses per 1000 never-breastfed infants compared with 1000 infants exclusively breastfed for at least 3 months. These additional health care services cost the managed care health system between $331 and $475 per never-breastfed infant during the first year of life.
In addition to having more illnesses, formula-fed infants cost the health care system money. Health care plans will likely realize substantial savings, as well as providing improved care, by supporting and promoting exclusive breastfeeding.
在对潜在混杂因素进行校正后，确定配方奶喂养婴儿在出生后第一年中三种疾病的额外医疗保健服务成本。
在图森儿童呼吸研究（n = 944）和邓迪社区研究（苏格兰研究，n = 644）中，评估了出生后第一年中三种疾病（下呼吸道疾病、中耳炎和胃肠道疾病）的医疗服务利用频率与纯母乳喂养持续时间的关系。两项研究中的婴儿出生时均健康，代表了基于人群的非选择性样本。根据婴儿出生后头3个月的喂养状况，将儿童分为从未母乳喂养、部分母乳喂养或纯母乳喂养。使用方差分析对三种疾病的门诊就诊频率和住院频率进行了产妇教育程度和产妇吸烟情况的校正。从医疗保健提供者/支付者的角度进行的成本估计基于1995年在一个大型管理式医疗保健系统中的直接医疗成本。
在出生后第一年，对混杂因素进行校正后，每1000名从未母乳喂养的婴儿与1000名至少纯母乳喂养3个月的婴儿相比，这三种疾病的额外门诊就诊次数为2033次，额外住院天数为212天，额外处方为609张。这些额外的医疗保健服务在出生后第一年使管理式医疗保健系统为每名从未母乳喂养的婴儿花费331美元至475美元。
除了患更多疾病外，配方奶喂养的婴儿还会给医疗保健系统带来经济成本。通过支持和促进纯母乳喂养，医疗保健计划可能会实现大幅节省并提供更好的护理。
