Aim: To estimate mean costs of neonatal care for babies with birthweights <or=1800 g in a regional Level 3 unit and three Level 2 units providing short-term intensive care.
Method: Babies <or=1800 g admitted to units in four hospitals in England over 15 months in 2001-2002 were audited until discharge. Unit costs (2005-2006 prices) were attributed to their resource items, including neonatal cot occupancy, pharmaceuticals, blood products and ambulance transfers. Bootstrapped mean costs were derived for the Level 3 unit and the Level 2 units combined.
Results: The mean gestation period for 199 Level 3 babies was 29.5 weeks compared with 30.4 weeks for 192 Level 2 babies (p = 0.003). Mean costs excluding ambulance journeys were pound17,861 per Level 3 baby and pound12,344 per Level 2 baby. Level 3 babies <1000 g averaged pound26,815, whereas Level 2 babies <1000 g were generally less costly than babies 1000-1499 g. Ambulances transported 76 Level 3 babies and 62 Level 2 babies; their adjusted mean costs were pound18,495 and pound12,881, respectively.
Conclusion: By comprehensively costing resource components, the magnitude of total costs for low-birthweight babies has been revealed, thus demonstrating the importance of budgets for neonatal units being realistically determined by commissioners of neonatal services.