Document Detail


How low birthweight and gestational age contribute to increased inpatient costs for multiple births.
MedLine Citation:
PMID:  9472231     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The dramatic rise in the number of multiple gestation births has led to concerns about heavy resource use by these newborns and the design of cost-effective interventions. This study uses medical records data to compare single and multiple births in terms of hospital charges by cost center, length of stay, neonatal intensive care unit (NICU) days, and discharge status. Potential mediators examined were gestational age and birthweight. These factors, respectively, accounted for 50% and 40% of the increase in total charges due to multiple gestation. The remaining "direct effect" was due primarily to longer hospital stays among twins and higher daily charges among higher-order multiples. Room and board charges were higher for multiples, while charges in other categories were actually lower, after controlling for birthweight and gestational age. Birthweight and gestational age accounted fully for the increased use of NICU services among multiples. These results show that while prevention of multiple gestation, where possible, is of paramount importance, strategies that decrease preterm delivery and/or increase birthweight should attenuate the adverse economic impact of multiple gestation pregnancies.
Authors:
S L Ettner; C L Christiansen; T L Callahan; J E Hall
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Inquiry : a journal of medical care organization, provision and financing     Volume:  34     ISSN:  0046-9580     ISO Abbreviation:  Inquiry     Publication Date:    1997-1998 Winter
Date Detail:
Created Date:  1998-03-11     Completed Date:  1998-03-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0171671     Medline TA:  Inquiry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  325-39     Citation Subset:  IM    
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Boston
Female
Gestational Age*
Health Services Research
Hospital Charges
Hospital Costs / statistics & numerical data*
Hospitals, Maternity / economics
Humans
Infant Mortality
Infant, Low Birth Weight*
Infant, Newborn
Intensive Care Units, Neonatal / economics*,  utilization
Male
Maternal Age
Multiple Birth Offspring* / statistics & numerical data
Pregnancy
Pregnancy, High-Risk
Grant Support
ID/Acronym/Agency:
HS07118-01/HS/AHRQ HHS; U54-HD-29164/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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