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Readmission Rates for Preemies
Underwood MA, Danielsen B and Gilbert WM. Cost, causes and rates of rehospitalization of preterm infants. Journal of Perinatology (October 2007); 27: 614–619.
Objective: To examine hospital readmissions for premature infants during the first year of life.
Study Design: The California maternal and newborn/infant hospital discharge records were examined for subsequent readmission during the first year of life for all newborns from 1992 to 2000. Discharge diagnoses, hospital days, demographic data and hospital charges for infants born preterm (<36 weeks gestation) were identified and evaluated.
Result: About 15% of preterm infants required at least one rehospitalization within the first year of life (average cost per readmission $8468, average annual cost in excess of $41 million). Infants with gestational age <25 weeks had the highest rate of readmission (31%) and longest average length of stay (12 hospital days). The largest cohort, infants born at 35 weeks gestation, had the highest total cost of readmission ($92.9 million). The most common cause of rehospitalization was acute respiratory disease. There was no decrease in the number or cost of readmissions of premature infants for respiratory syncytial virus infections following the introduction of palivizumab in 1998.
Conclusion: After initial discharge, premature infants continue to have significant in-patient health-care needs and costs.
Comments. The major reason for rehospitalization of preterm infants was an acute respiratory illness, often an infection with Respiratory Syncytial Virus (RSV). It was very interesting to note that the number or cost of readmissions due to RSV in premature infants did not decrease following the introduction of Palivizumab (Synagis®) in 1998. Perhaps we should repeat the cost and benefit analysis behind the current AAP recommendation for Synagis® use in premature infants. ABK
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