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The economic impact of prematurity and bronchopulmonary dysplasia

Abstract

Bronchopulmonary dysplasia (BPD) is one of the most serious chronic lung diseases in infancy and one of the most important sequels of premature birth (prevalence of 15–50%). Our objective was to estimate the cost of BPD of one preterm baby, with no other major prematurity-related complications, during the first 2 years of life in Spain. Data from the Spanish Ministry of Health regarding costs of diagnosis-related group of preterm birth, hospital admissions and visits, palivizumab administration, and oxygen therapy in the year 2013 were analyzed. In 2013, 2628 preterm babies were born with a weight under 1500 g; 50.9% were males. The need for respiratory support was 2.5% needed only oxygen therapy, 39.5% required conventional mechanical ventilation, and 14.9% required high-frequency ventilation. The incidence of BPD was of 34.9%. The cost of the first 2 years of life of a preterm baby with BPD and no other major prematurity-related complications ranged between 45,049.81 € and 118,760.43 €, in Spain, depending on birth weight and gestational age. If the baby required home oxygen therapy or developed pulmonary hypertension, this cost could add up to 181,742.43 €.

Conclusion: Prematurity and BPD have an elevated cost, even for public health care systems. This cost will probably increase in the coming years if the incidence and survival of preterm babies keeps rising. The development of new therapies and preventive strategies to decrease the incidence of BPD and other morbidities associated with prematurity should be a priority.

What is known:
• Bronchopulmonary dysplasia (BPD) is a serious chronic lung disease related with premature birth.
• BPD is an increasing disease due to the up-rise in the number of premature births.
What is new:
• The economic cost of preterm birth and BPD has never before been estimated in Spain nor published with European data.
• Preterm babies with BPD and a good clinical outcome carry also an important economic and social burden.

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Abbreviations

BPD:

Bronchopulmonary dysplasia

DRG:

Diagnostic-related groups

PH:

Pulmonary hypertension

VLBW:

Very low birth weight

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Acknowledgments

We would like to thank the Fundación contra la Hipertensión Pulmonar for funding this study.

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Authors and Affiliations

Authors

Contributions

Dr. Álvarez has conceptualized and designed the study, searched for the data sources, analyzed the data, drafted the initial manuscript, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Dr. Arruza has collected data, carried out the initial data analyses, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Dr. Muro has conceptualized and designed the study, drafted the initial manuscript, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Dr. Zozaya has collected data, analyzed the data, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Dr. Ávila has collected data, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Dr. López Ortego has contributed in the writing and reviewing of the final manuscript and approved the final manuscript as submitted.

Dr. González Armengod has collected data, carried out the initial data analyses, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Dr. Torrent contributed in the recollection of the data, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Dr. Gavilán contributed in the recollection of the data, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Dr. del Cerro has conceptualized and designed the study, analyzed the data, drafted the initial manuscript, contributed in the writing and reviewing of the final manuscript, and approved the final manuscript as submitted.

Corresponding author

Correspondence to María Álvarez-Fuente.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Disclosure

All authors have indicated they have no financial relationships relevant to this article to disclose.

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Communicated by Patrick Van Reempts

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Álvarez-Fuente, M., Arruza, L., Muro, M. et al. The economic impact of prematurity and bronchopulmonary dysplasia. Eur J Pediatr 176, 1587–1593 (2017). https://doi.org/10.1007/s00431-017-3009-6

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  • DOI: https://doi.org/10.1007/s00431-017-3009-6

Keywords

  • Bronchopulmonary dysplasia
  • Preterm birth
  • Pulmonary hypertension
  • Prematurity economic impact