Abstract
The health conditions associated with extreme prematurity will likely require life-long treatment and management. As such, planning for the provision of healthcare services is essential in order to maximise their long-term well-being. We sought to quantify the use of healthcare services and the associated costs for extremely premature babies compared to preterm and term babies in Australia using a whole-of-population linked administrative dataset. In the first year of life, extremely premature babies had an average of 3.4 hospital admissions, and 2 emergency department presentations. They also had an average of 16 specialist attendances, 33 pathology tests and 6 diagnostic imaging tests performed. This was more than that utilised by preterm and full-term babies. The mean annual cost of hospitalisations was $182,312 for extremely premature babies in the first year and $9958 in the second year. The mean annual out-of-pocket fees for these services were $2212 and $121 in the first and second years respectively.
Conclusion: Understanding the long-term healthcare needs of extremely premature babies in order to provide both an adequate number of services and also connection between services should be a central part of health system planning as the survival rates of extremely premature babies improve over time.
What is Known: • The health service use of extremely premature babies is higher at the time of birth. • Health conditions and disabilities associated with extreme prematurity require life-long care. | |
What is New: • Extremely premature babies have more diverse and frequent access to services than premature and term babies until at least age 2. • This comes at higher cost to families through out-of-pocket payments. |
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Our ethics approvals prohibit the sharing of data.
Abbreviations
- ICU:
-
Intensive care unit
- MBS:
-
Medicare Benefits Schedule
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Acknowledgements
We wish to thank the Queensland Health Statistical Service Branch and Australian Institute of Health and Welfare for conducting the data linkage for this study.
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EC received funding from the National Health and Medical Research Council under the Career Development Fellowship scheme (APP1159536).
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EC conceived the study, undertook the analysis and drafted the manuscript. EC and KA co-designed the analysis, interpreted the results and edited the final manuscript.
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Ethics approval for the use of the Maternity1000 dataset was obtained from the Townsville Hospital and Health Service Human Research Ethics Committee (HREC) (HREC/16/QTHS/223), James Cook University HREC (H7246) and the Australian Institute of Health and Welfare HREC (EO2017-1-338). We also received Public Health Act Approval (RD007377) to waive consent for data collection.
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Communicated by Daniele De Luca
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Callander, E.J., Atwell, K. The healthcare needs of preterm and extremely premature babies in Australia—assessing the long-term health service use and costs with a data linkage cohort study. Eur J Pediatr 180, 2229–2236 (2021). https://doi.org/10.1007/s00431-021-04009-y
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DOI: https://doi.org/10.1007/s00431-021-04009-y