Lee Ji Young, Park Joonsik, Lee Myeongjee, Han Minkyung, Lim Sung Min, Baek Jee Yeon, Kang Ji-Man, Park Min Soo, Jung Inkyung, Ahn Jong Gyun
Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Sci Rep. 2025 Apr 24;15(1):14357. doi: 10.1038/s41598-025-98868-2.
Despite the decline in the overall birth rate, increasing preterm births and associated medical costs pose a national concern. We analyze hospitalization costs covered by national public insurance for preterm infants. Population-based data, obtained from the National Health Insurance Service (NHIS), which is operated by the Health Insurance Review and Assessment Service, were used for the study. Preterm births from January 1, 2008 to December 31, 2020 were included, using International Classification of Diseases and Related Health Problems, 10th edition (P07.2, extremely preterm < 28 weeks gestational age, P07.3, non-extremely preterm). The primary outcomes related to cost from the first hospitalization due to preterm births and medication, and laboratory, radiological, and functional tests by gestational age and birth weight. Additionally, we assessed the readmission rates of preterm infants and the associated medical costs. A total of 5,312,886 live infants were born, of which 90,575 were claimed as preterm birth hospitalization. The total medical cost per patient increased almost three-fold from $7,390.90 to $20,209.59 from 2008 to 2020; for the extremely preterm group, it increased four-fold ($13,961.03 to $55,984.47). The readmission rate within 90 days of discharge was 62.5%; however, a greater proportion of the extremely preterm, as compared to the non-extremely preterm (16.1% vs. 8.32%, P < 0.001) group was readmitted within 30 days. The extremely preterm group also incurred higher costs associated with readmission (mean $4293.8 vs. $2975.4, P < 0.001). This study reveals not only the increase in preterm birth rate in South Korea, but also in the associated medical costs. Further attention should be paid to efficient resource allocation at the national level to relieve the medical burden of preterm births.
尽管总体出生率有所下降，但早产率上升及其相关医疗成本已成为全国关注的问题。我们分析了国家公共保险覆盖的早产婴儿住院费用。本研究使用了由健康保险审查评估服务机构运营的国民健康保险服务（NHIS）提供的基于人群的数据。纳入了2008年1月1日至2020年12月31日的早产病例，采用国际疾病分类及相关健康问题第十版（P07.2，极早产＜28周胎龄，P07.3，非极早产）。主要结局包括早产及用药首次住院的费用，以及按胎龄和出生体重划分的实验室、放射学和功能检查费用。此外，我们评估了早产婴儿的再入院率及相关医疗成本。共有5312886名活产婴儿出生，其中90575名被认定为早产住院病例。从2008年到2020年，每位患者的总医疗费用几乎增长了两倍，从7390.90美元增至20209.59美元；极早产组增长了四倍（从13961.03美元增至55984.47美元）。出院后90天内的再入院率为62.5%；然而，与非极早产组相比，极早产组在30天内再入院的比例更高（16.1%对8.32%，P＜0.001）。极早产组再入院相关费用也更高（平均4293.8美元对2975.4美元，P＜0.001）。这项研究不仅揭示了韩国早产率的上升，还显示了相关医疗成本的增加。应在国家层面进一步关注有效资源分配，以减轻早产的医疗负担。
