Institute of Business Analytics, The University of Alabama, Tuscaloosa.
Institute of Data and Analytics, The University of Alabama, Tuscaloosa.
JAMA Netw Open. 2024 Feb 5;7(2):e240295. doi: 10.1001/jamanetworkopen.2024.0295.
Neonatal abstinence syndrome (NAS) is a medical condition among neonates experiencing substance withdrawal due to the mother's substance use during pregnancy. While previous studies suggest that the overall incidence and annual costs of NAS are increasing, to date, the long-term costs have yet to be demonstrated in Medicaid populations.
To examine the demographic differences and long-term costs of care for neonates diagnosed with vs not diagnosed with NAS.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used claims data from the Alabama Medicaid Agency for neonates born to Medicaid-eligible mothers between January 1, 2010, and December 31, 2020. Data were analyzed in June 2022.
A diagnosis of NAS within 30 days of birth.
Rate of NAS by demographic and birth characteristics, long-term costs attributable to NAS status and demographic and birth characteristics, and distribution of this expenditure over the enrollment period.
A total of 346 259 neonates with Medicaid eligibility were born during the study period (mean [SD] gestational age, 38.4 [2.2] weeks; 50.5%, male), 4027 (1.2%) of whom had an NAS diagnosis within 30 days of birth. A larger percentage of neonates with an NAS diagnosis were male (52.7%) than in the group without NAS (50.5%). Neonates with NAS also weighed less at birth (mean difference, -212.0 g; 95% CI, -231.1 to -192.8 g) and had older mothers (mean difference, 3.4 years; 95% CI, 2.6-4.2 years). An NAS diagnosis had an estimated additional cost of $17 921 (95% CI, $14 830-$21 012) over the enrollment period, and this cost was not evenly distributed over that period.
In this cohort study of neonates born into the Alabama Medicaid population, those with an NAS diagnosis had a different demographic profile and a higher cost to state Medicaid agencies than those without NAS. These findings warrant further effort to reduce the occurrence of NAS.
新生儿戒断综合征（NAS）是一种医学病症，发生在母亲怀孕期间使用物质导致新生儿戒断的情况下。尽管之前的研究表明，NAS 的总体发病率和年成本正在增加，但迄今为止，在医疗补助人群中尚未证明长期成本。
研究诊断为和未诊断为 NAS 的新生儿的人口统计学差异和长期护理成本。
设计、设置和参与者：这项队列研究使用了来自阿拉巴马州医疗补助机构的索赔数据，该数据来自 2010 年 1 月 1 日至 2020 年 12 月 31 日期间符合医疗补助条件的母亲所生的新生儿。数据于 2022 年 6 月进行分析。
出生后 30 天内诊断为 NAS。
根据人口统计学和出生特征的 NAS 发生率、归因于 NAS 状况和人口统计学及出生特征的长期成本，以及该支出在入组期间的分布情况。
在研究期间，共有 346259 名符合医疗补助条件的新生儿出生（平均[SD]胎龄为 38.4[2.2]周；50.5%为男性），其中 4027 名（1.2%）新生儿在出生后 30 天内被诊断为 NAS。患有 NAS 的新生儿中男性（52.7%）的比例大于无 NAS 的新生儿（50.5%）。患有 NAS 的新生儿出生时体重也较轻（平均差异为-212.0g；95%CI，-231.1 至-192.8g），母亲年龄较大（平均差异为 3.4 岁；95%CI，2.6-4.2 岁）。在入组期间，NAS 诊断的估计额外费用为 17921 美元（95%CI，14830 美元至 21012 美元），而且这笔费用在入组期间的分布并不均匀。
在这项针对阿拉巴马州医疗补助人群中出生的新生儿的队列研究中，与无 NAS 的新生儿相比，诊断为 NAS 的新生儿具有不同的人口统计学特征和更高的州医疗补助机构成本。这些发现需要进一步努力来减少 NAS 的发生。
