新生儿重症监护病房出院儿童的医疗保健支出和利用情况。
Health-care spending and utilization for children discharged from a neonatal intensive care unit.
机构信息
Department of Pediatrics, University at Buffalo, Buffalo, NY, USA.
Complex Care Service, Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
出版信息
J Perinatol. 2018 Jun;38(6):734-741. doi: 10.1038/s41372-018-0055-5. Epub 2018 Feb 15.
OBJECTIVES
To describe health-care spending and utilization for infants discharged from the neonatal intensive care unit (NICU).
STUDY DESIGN
Retrospective cohort analysis of 4973 NICU graduates in the Truven MarketScan Medicaid database, with follow-up to the third birthday. Health-care spending and utilization after NICU discharge were assessed. Using logistic regression, we assessed clinical characteristics associated with hospitalization and emergency department (ED) visits.
RESULTS
Most (69.5%) post-NICU spending occurred within the first year [$33,276 per member per year]. Inpatient care accounted for most (71.6%) of the 3-year spending. The percentages of infants with a 1-year readmission or ED visit were 36.8% and 63.7%, respectively. Medical technology was associated with the highest likelihoods of hospital [aOR 17.8 (95%CI 12.2-26.0)] and ED use [aOR 2.3 (95%CI 1.8-3.0)].
CONCLUSIONS
Hospital care accounts for the majority of spending for NICU graduates. Infants with medical technology have the highest risk of hospital and ED use.
目的
描述新生儿重症监护病房（NICU）出院婴儿的医疗保健支出和利用情况。
研究设计
对 Truven MarketScan 医疗补助数据库中 4973 名 NICU 毕业生进行回顾性队列分析，随访至 3 岁生日。评估 NICU 出院后的医疗保健支出和利用情况。使用逻辑回归评估与住院和急诊部（ED）就诊相关的临床特征。
结果
大多数（69.5%）NICU 后支出发生在第一年[每名成员每年 33276 美元]。住院治疗占 3 年支出的大部分（71.6%）。一年内再入院或 ED 就诊的婴儿比例分别为 36.8%和 63.7%。医疗技术与住院[优势比（aOR）17.8（95%CI 12.2-26.0）]和 ED 使用[aOR 2.3（95%CI 1.8-3.0）]的可能性最高相关。
结论
医院护理占 NICU 毕业生支出的大部分。使用医疗技术的婴儿有最高的住院和 ED 使用风险。
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