Low socio-economic conditions and prematurity-related morbidities explain healthcare use and costs for 2-year-old very preterm children

Michela Meregaglia, Ileana Croci, Carla Brusco, Lena C Herich, Domenico Di Lallo, Giancarlo Gargano, Virgilio Carnielli, Jennifer Zeitlin, Giovanni Fattore, Marina Cuttini

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: To estimate healthcare use and related costs for 2-year-old very preterm (VP) children after discharge from the neonatal unit.

METHODS: As part of a European project, we recruited an area-based cohort including all VP infants born in three Italian regions (Lazio, Emilia-Romagna and Marche) in 2011-2012. At 2 years corrected age, parents completed a questionnaire on their child health and healthcare use (N = 732, response rate 75.6%). Cost values were assigned based on national reimbursement tariffs. We used multivariable analyses to identify factors associated with any rehospitalisation and overall healthcare costs.

RESULTS: The most frequently consulted physicians were the paediatrician (85% of children), the ophthalmologist (36%) and the neurologist/neuropsychiatrist (26%); 38% of children were hospitalised at least once after the initial discharge, for a total of 513 admissions and over one million euros cost, corresponding to 75% of total healthcare costs. Low maternal education and parental occupation index, congenital anomalies and postnatal prematurity-related morbidities significantly increased the risk of rehospitalisation and total healthcare costs.

CONCLUSION: Rehospitalisation and outpatient care are frequent in VP children, confirming a substantial health and economic burden. These findings should inform the allocation of resources to preventive and rehabilitation services for these children.

Original languageEnglish
Pages (from-to)1791-1800
Number of pages10
JournalActa Paediatr. Int. J. Paediatr.
Volume109
Issue number9
DOIs
Publication statusPublished - Sep 2020

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