McLaurin Kimmie K, Wade Sally W, Kong Amanda M, Diakun David, Olajide Ifedapo R, Germano Jane
US Medical Affairs, AstraZeneca, Gaithersburg, MD, USA,
Wade Outcomes Research and Consulting, Salt Lake City, UT, USA.
Pediatric Health Med Ther. 2019 Apr 5;10:21-31. doi: 10.2147/PHMT.S182296. eCollection 2019.
This study examined health care utilization and costs during the first year of life for preterm and full-term infants in the US.
Preterm (<37 weeks gestational age [GA]) and full-term infants born 2003 to 2012 without complex medical conditions were identified in the MarketScan Commercial and Multi-State Medicaid claims databases using ICD-9-CM diagnosis and diagnosis-related grouping codes. Inpatient and outpatient claims from birth through the first year were analyzed for preterm and full-term subgroups. Results were stratified by payer.
There were 1,692,935 commercially insured infants (12.5% preterm) and 1,873,324 Medicaid-insured infants (13.9% preterm). The majority (>75%) of preterm infants were admitted to the neonatal intensive care unit during their birth hospitalization. Generally, mean length of stay and costs for birth hospitalizations increased with decreasing GA. The average cost of a birth hospitalization was US $62,931 (SD $134,347) for commercially insured preterm infants and $43,858 (SD $115,412) for Medicaid-insured preterm infants compared to $2,401 (SD $7,399) and $1,894 (SD $5,444) for commercially insured and Medicaid-insured full-term infants, respectively. Post-neonatal hospitalization rates increased as GA decreased (in full-term to <29 weeks GA: commercial =3.3%-19.5%; Medicaid =6.1%-26.2%). Preterm infants had greater average numbers of outpatient office visits and pharmacy claims than full-term infants. Following birth discharge, mean monthly health care costs per infant increased as GA decreased (commercial = $334 to $3,126; Medicaid = $205 to $2,473).
During the first year of life, post-neonatal hospitalization rates, outpatient office visits, pharmacy claims, and monthly costs increased as GA decreased.
本研究调查了美国早产和足月婴儿出生后第一年的医疗保健利用情况及费用。
利用ICD - 9 - CM诊断和诊断相关分组代码，在MarketScan商业保险和多州医疗补助索赔数据库中识别出2003年至2012年出生、无复杂医疗状况的早产（胎龄<37周[GA]）和足月婴儿。分析早产和足月亚组从出生到一岁的住院和门诊索赔情况。结果按付款人分层。
有1,692,935名商业保险婴儿（12.5%为早产）和1,873,324名医疗补助保险婴儿（13.9%为早产）。大多数（>75%）早产婴儿在出生住院期间被收治入新生儿重症监护病房。一般来说，出生住院的平均住院时间和费用随着胎龄的降低而增加。商业保险早产婴儿出生住院的平均费用为62,931美元（标准差134,347美元），医疗补助保险早产婴儿为43,858美元（标准差115,412美元），相比之下，商业保险和医疗补助保险足月婴儿分别为2,401美元（标准差7,399美元）和1,894美元（标准差5,444美元）。出生后住院率随着胎龄的降低而增加（足月至<29周胎龄：商业保险 = 3.3% - 19.5%；医疗补助保险 = 6.1% - 26.2%）。早产婴儿的门诊就诊和药房索赔平均次数比足月婴儿多。出生出院后，每个婴儿的平均每月医疗保健费用随着胎龄的降低而增加（商业保险 = 334美元至3,126美元；医疗补助保险 = 205美元至2,473美元）。
在出生后第一年，出生后住院率、门诊就诊、药房索赔和每月费用随着胎龄的降低而增加。
