Penn State College of Medicine, Department of Pediatrics, Division of Newborn Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
Departments of Surgery and Public Health Sciences, Division of Outcomes Research and Quality, Penn State College of Medicine, Hershey, PA, USA.
Addiction. 2017 Sep;112(9):1590-1599. doi: 10.1111/add.13842. Epub 2017 Jun 13.
While hospital charges related to neonatal abstinence syndrome (NAS) have increased recently, there are no data available regarding costs. Therefore, we sought to describe the NAS population and compare with the non-NAS population, determine the incidence of NAS in the United States and estimate the total annual costs and hospital days of NAS admissions, and estimate the incremental costs and length of stay of an NAS admission compared with a non-NAS admission.
Retrospective, observational study. Data were obtained from the Kids' Inpatient Database (2003-12). Survey-weighting was used to obtain national counts of NAS births. The incremental burden of costs and length of stay were estimated for NAS admissions and compared to non-NAS admissions.
United States hospitals from states participating in the Kids' Inpatient Database (KID), a nationally representative sample of all-payer in-patient pediatric discharges.
Infants with a diagnosis of NAS (27 943) were identified from the KID using ICD-9-CM codes and compared with non-NAS infants (3 783 629).
Primary outcome measures were provider costs and length of stay for NAS and non-NAS admissions. Costs were calculated using cost-to-charge ratios and were adjusted for inflation to 2014 US dollars.
Between 2003 and 2012, NAS admissions increased more than fourfold, resulting in a surge in annual costs from US$61 million and 67 869 hospital days in 2003 to nearly US$316 million and 291 168 hospital days in 2012. For an infant affected by NAS, the hospital stay was nearly 3.5 times as long (16.57 hospital days compared with 4.98 for a non-NAS patient, P < 0.001) and the costs more than three times greater (US$16 893 compared to US$5610 for a non-affected infant, P < 0.001).
The incidence of neonatal abstinence syndrome is increasing in the United States, and carries an enormous burden in terms of hospital days and costs. The number of US hospital admissions involving neonatal abstinence syndrome increased more than fourfold between the years 2003 and 2012. In 2012, neonatal abstinence syndrome cost nearly $316 million in the United States.
尽管与新生儿戒断综合征（NAS）相关的医院费用最近有所增加，但目前尚无有关成本的数据。因此，我们旨在描述 NAS 人群，并与非-NAS 人群进行比较，确定美国 NAS 的发病率，并估计 NAS 入院的总年度费用和住院天数，以及估计与非-NAS 入院相比，NAS 入院的增量成本和住院时间。
回顾性观察性研究。数据来自儿童住院数据库（2003-12 年）。使用调查加权法获得全国范围内 NAS 分娩的出生人数。估计 NAS 入院的增量费用和住院时间负担，并与非-NAS 入院进行比较。
来自参加儿童住院数据库（KID）的美国各州的医院，KID 是所有支付方住院儿科出院的全国代表性样本。
使用 ICD-9-CM 代码从 KID 中确定患有 NAS（27943 例）的婴儿，并与非-NAS 婴儿（3783629 例）进行比较。
NAS 和非-NAS 入院的医疗服务提供者成本和住院时间。使用成本与收费比计算成本，并根据 2014 年的通货膨胀率进行调整，以换算为美元。
2003 年至 2012 年间，NAS 入院人数增加了四倍多，导致年度费用从 2003 年的 6100 万美元和 67869 天住院时间增加到 2012 年的近 3.16 亿美元和 291168 天住院时间。对于受 NAS 影响的婴儿，住院时间几乎长了 3.5 倍（16.57 天住院时间，而非 NAS 患者为 4.98 天，P<0.001），费用增加了三倍多（16893 美元，而非受影响婴儿为 5610 美元，P<0.001）。
在美国，新生儿戒断综合征的发病率正在增加，并且在住院时间和费用方面带来了巨大的负担。2003 年至 2012 年间，涉及新生儿戒断综合征的美国医院入院人数增加了四倍多。2012 年，新生儿戒断综合征在美国的费用接近 3.16 亿美元。
