比较以人乳或牛乳为基础的强化剂补充喂养出生体重<1250g 的三级 NICU 婴儿的成本。
A comparison of tertiary level NICU costs for infants born <1250 g supplemented with human versus bovine milk-based fortifiers.
机构信息
Department of Pediatrics, Sinai Health, Toronto, ON, Canada.
Section of Neonatology, Windsor Regional Hospital, Windsor, ON, Canada.
出版信息
J Perinatol. 2023 Sep;43(9):1113-1118. doi: 10.1038/s41372-023-01677-6. Epub 2023 Apr 21.
BACKGROUND
Human milk-based fortifiers (HMBF) are more costly than bovine milk-based fortifiers (BMBF); but, the efficacy of human or bovine fortification for infants born <1250 g has yet to be fully elucidated. Our objective was to determine the effect of fortifier source on tertiary neonatal costs.
METHODS
Costs associated with tertiary neonatal care, including direct and indirect hospital expenditures, feed-related costs and physician billing were analysed retrospectively for participants of OptiMoM (NCT02137473), a blinded RCT comparing fortifier type for babies born <1250 g. A generalized linear model of cost according to fortifier type was created.
RESULTS
Mean [95% confidence interval] daily costs per patient, adjusted for birth gestation and weight, was significantly greater in the human than the BMBF group ($3,452 [$3,186 - $3,740] Canadian dollars (CAD) versus $2,451 [$2,257 - $2,662] CAD) respectively, p < 0.0001).
CONCLUSION
HMBF usage entails additional costs on NICU stay that should be considered with implementation.
背景
人乳基强化剂（HMBF）比牛乳基强化剂（BMBF）成本更高；但是，对于出生体重<1250g 的婴儿，人乳或牛乳强化的效果尚未完全阐明。我们的目的是确定强化剂来源对三级新生儿成本的影响。
方法
回顾性分析 OptiMoM（NCT02137473）参与者的三级新生儿护理相关成本，包括直接和间接医院支出、与喂养相关的成本和医生计费。根据强化剂类型创建了成本的广义线性模型。
结果
根据出生胎龄和体重调整后的每位患者的平均（95%置信区间）每日费用，人乳组明显高于 BMBF 组（3452 加元（CAD）[3186-3740 CAD] 与 2451 加元（CAD）[2257-2662 CAD]，p<0.0001）。
结论
HMBF 的使用会增加新生儿重症监护病房（NICU）停留的额外成本，在实施时应予以考虑。
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