Direct costs of prematurity and factors associated with birth and maternal conditions
ABSTRACT OBJECTIVE To estimate the direct costs due to hospital care for extremely, moderate, and late preterm newborns, from the perspective of a public hospital in 2018. The second objective was to investigate whether factors associated with birth and maternal conditions explain the costs and le...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Universidade de São Paulo
2022-06-01
|
| Series: | Revista de Saúde Pública |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100240&lng=en&tlng=en |
| _version_ | 1818470801728339968 |
|---|---|
| author | Thamires Francelino Mendonça de Melo Rodrigo Luiz Carregaro Wildo Navegantes de Araújo Everton Nunes da Silva Aline Martins de Toledo |
| author_facet | Thamires Francelino Mendonça de Melo Rodrigo Luiz Carregaro Wildo Navegantes de Araújo Everton Nunes da Silva Aline Martins de Toledo |
| author_sort | Thamires Francelino Mendonça de Melo |
| collection | DOAJ |
| description | ABSTRACT OBJECTIVE To estimate the direct costs due to hospital care for extremely, moderate, and late preterm newborns, from the perspective of a public hospital in 2018. The second objective was to investigate whether factors associated with birth and maternal conditions explain the costs and length of hospital stay. METHODS This is a cost-of-illness study, with data extracted from hospital admission authorization forms and medical records of a large public hospital in the Federal District, Brazil. The association of characteristics of preterm newborns and mothers with costs was estimated by linear regression with gamma distribution. In the analysis, the calculation of the parameters of the estimates (B), with a confidence interval of 95% (95%CI), was adopted. The uncertainty parameters were estimated by the 95% confidence interval and standard error using the Bootstrapping method, with 1,000 samples. Deterministic sensitivity analysis was performed, considering lower and upper limits of 95%CI in the variation of each cost component. RESULTS A total of 147 preterm newborns were included. We verified an average cost of BRL 1,120 for late preterm infants, BRL 6,688 for moderate preterm infants, and BRL 17,395 for extremely preterm infants. We also observed that factors associated with the cost were gestational age (B = -123.00; 95%CI: -241.60 to -4.50); hospitalization in neonatal ICU (B = 6,932.70; 95%CI: 5,309.40–8,556.00), and number of prenatal consultations (B = -227.70; 95%CI: -403.30 to -52.00). CONCLUSIONS We found a considerable direct cost resulting from the care of preterm newborns. Extreme prematurity showed a cost 15.5 times higher than late prematurity. We also verified that a greater number of prenatal consultations and gestational age were associated with a reduction in the costs of prematurity. |
| first_indexed | 2024-04-13T21:42:25Z |
| format | Article |
| id | doaj.art-3875a24de6544c049175938ce4477dae |
| institution | Directory Open Access Journal |
| issn | 1518-8787 |
| language | English |
| last_indexed | 2024-04-13T21:42:25Z |
| publishDate | 2022-06-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-3875a24de6544c049175938ce4477dae2022-12-22T02:28:42ZengUniversidade de São PauloRevista de Saúde Pública1518-87872022-06-015610.11606/s1518-8787.2022056003657Direct costs of prematurity and factors associated with birth and maternal conditionsThamires Francelino Mendonça de Melohttps://orcid.org/0000-0003-4664-1703Rodrigo Luiz Carregarohttps://orcid.org/0000-0002-2382-0787Wildo Navegantes de Araújohttps://orcid.org/0000-0002-6856-4094Everton Nunes da Silvahttps://orcid.org/0000-0001-8747-4185Aline Martins de Toledohttps://orcid.org/0000-0002-0041-0750ABSTRACT OBJECTIVE To estimate the direct costs due to hospital care for extremely, moderate, and late preterm newborns, from the perspective of a public hospital in 2018. The second objective was to investigate whether factors associated with birth and maternal conditions explain the costs and length of hospital stay. METHODS This is a cost-of-illness study, with data extracted from hospital admission authorization forms and medical records of a large public hospital in the Federal District, Brazil. The association of characteristics of preterm newborns and mothers with costs was estimated by linear regression with gamma distribution. In the analysis, the calculation of the parameters of the estimates (B), with a confidence interval of 95% (95%CI), was adopted. The uncertainty parameters were estimated by the 95% confidence interval and standard error using the Bootstrapping method, with 1,000 samples. Deterministic sensitivity analysis was performed, considering lower and upper limits of 95%CI in the variation of each cost component. RESULTS A total of 147 preterm newborns were included. We verified an average cost of BRL 1,120 for late preterm infants, BRL 6,688 for moderate preterm infants, and BRL 17,395 for extremely preterm infants. We also observed that factors associated with the cost were gestational age (B = -123.00; 95%CI: -241.60 to -4.50); hospitalization in neonatal ICU (B = 6,932.70; 95%CI: 5,309.40–8,556.00), and number of prenatal consultations (B = -227.70; 95%CI: -403.30 to -52.00). CONCLUSIONS We found a considerable direct cost resulting from the care of preterm newborns. Extreme prematurity showed a cost 15.5 times higher than late prematurity. We also verified that a greater number of prenatal consultations and gestational age were associated with a reduction in the costs of prematurity.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100240&lng=en&tlng=enInfant, PrematurePerinatal Care, economicsCosts and Cost AnalysisIntensive Care Units, NeonatalMaternal and Child Health |
| spellingShingle | Thamires Francelino Mendonça de Melo Rodrigo Luiz Carregaro Wildo Navegantes de Araújo Everton Nunes da Silva Aline Martins de Toledo Direct costs of prematurity and factors associated with birth and maternal conditions Revista de Saúde Pública Infant, Premature Perinatal Care, economics Costs and Cost Analysis Intensive Care Units, Neonatal Maternal and Child Health |
| title | Direct costs of prematurity and factors associated with birth and maternal conditions |
| title_full | Direct costs of prematurity and factors associated with birth and maternal conditions |
| title_fullStr | Direct costs of prematurity and factors associated with birth and maternal conditions |
| title_full_unstemmed | Direct costs of prematurity and factors associated with birth and maternal conditions |
| title_short | Direct costs of prematurity and factors associated with birth and maternal conditions |
| title_sort | direct costs of prematurity and factors associated with birth and maternal conditions |
| topic | Infant, Premature Perinatal Care, economics Costs and Cost Analysis Intensive Care Units, Neonatal Maternal and Child Health |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100240&lng=en&tlng=en |
| work_keys_str_mv | AT thamiresfrancelinomendoncademelo directcostsofprematurityandfactorsassociatedwithbirthandmaternalconditions AT rodrigoluizcarregaro directcostsofprematurityandfactorsassociatedwithbirthandmaternalconditions AT wildonavegantesdearaujo directcostsofprematurityandfactorsassociatedwithbirthandmaternalconditions AT evertonnunesdasilva directcostsofprematurityandfactorsassociatedwithbirthandmaternalconditions AT alinemartinsdetoledo directcostsofprematurityandfactorsassociatedwithbirthandmaternalconditions |