The Cost of Newborn Care in NICU of Somdejprasangkharach 17 th Hospital

Abstract

Objectives : To assess the factors affecting the hospital costs of newborn care in NICU of Somdejprasangkharach 17 Hospital from January 1st to December 31st, 2015 and compare the hospital costs to the re-imbursement from National Health Security Office Fund.

Methods : This is the retrospective study. January1st, to December 31st, 2015 were enrolled. The data of newborns admitted to NICU including gender, birth weight, gestational age, mode of delivery, ventilation days, interventions (UAC, UVC, PICC), length of hospital stay, diagnosis, hospital cost and re-imbursement from National Health Security Office fund were collected from medical records and hospital databases. Using descriptive statistics and inferential statistics for data analysis (frequency, percentage, mean, standard deviation, Pearson’s chi-square, one-way ANOVA and Kruskal-Wallis test)

Results : 181 newborns were enrolled. The average birth weight was 2,601.5 ± 738.5 grams, mean gestational age was 36.04 ± 3.08 weeks, 43.6% of newborns were ventilated and an average ventilation days was of 4.74 ±6.22. The average length of hospital stay was 8.49 ±16.61 days. The highest hospital cost was amonginfants weighing less than 1,000 grams at average of 188,277.6 ± 125,317 baht/person and among the gestational age less than 32 weeks at average of 113,418.2 ± 115,574.83 baht / person with statistically significant (p <0.001). The highest costs over re-imbursement among newborns weighing less than 1,000 grams at average of 80,978.25 ± 85,189.06 baht/ person and among the gestational age less than 32 weeks at average of 27,098.89 ± 73,254.36 baht/ person. The lowest loss was among newborns weighing 1,500-2,499 grams at average of 298.32 ± 3,189.37 baht /person and in gestational age 33-37 weeks at average of 1,000.41 ± 27,633.79 baht/ person, but without statistically significant. The longest length of hospital days was among the newborns weighed 1,000-1,499 grams at 42.8 ± 51.16 days and mean gestational among infants age less than 32 weeks was 27.1 ± 35.8 days (p <0.001). The number of intervention was maximum among the newborn group weighing less than 1,000 grams (100%) and the gestational age less than 32 weeks (53.6%), with statistically significant (p<0.001).

Conclusion: The birth weight less than 1,000 grams and gestational age less than 32 weeks had the highest cost and the highest loss of newborn care in NICU.Due to the longer hospital stay and more interventions. Otherwise, costs and loss decrease as birth weight and gestational age increases.