Health-care spending and utilization for children discharged from a neonatal intensive care unit

J Perinatol. 2018 Jun;38(6):734-741. doi: 10.1038/s41372-018-0055-5. Epub 2018 Feb 15.


Objectives: To describe health-care spending and utilization for infants discharged from the neonatal intensive care unit (NICU).

Study design: Retrospective cohort analysis of 4973 NICU graduates in the Truven MarketScan Medicaid database, with follow-up to the third birthday. Health-care spending and utilization after NICU discharge were assessed. Using logistic regression, we assessed clinical characteristics associated with hospitalization and emergency department (ED) visits.

Results: Most (69.5%) post-NICU spending occurred within the first year [$33,276 per member per year]. Inpatient care accounted for most (71.6%) of the 3-year spending. The percentages of infants with a 1-year readmission or ED visit were 36.8% and 63.7%, respectively. Medical technology was associated with the highest likelihoods of hospital [aOR 17.8 (95%CI 12.2-26.0)] and ED use [aOR 2.3 (95%CI 1.8-3.0)].

Conclusions: Hospital care accounts for the majority of spending for NICU graduates. Infants with medical technology have the highest risk of hospital and ED use.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child, Preschool
  • Cohort Studies
  • Continuity of Patient Care / economics*
  • Databases, Factual
  • Emergency Service, Hospital / economics*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Health Care Costs*
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal / economics*
  • Length of Stay / economics
  • Logistic Models
  • Male
  • Medicaid / economics*
  • Patient Discharge
  • Patient Readmission / economics
  • Retrospective Studies
  • United States