J. Paediatr. Child Health (1992) 28, 410

Letter to the Editor

26 June 1992 Dear Editors COST ANALYSIS OF WTREMELY LOW BIRTHWEIGHT INFANTS: AN UPDATE World-wide studies of secular trends in mortality and morbidity for very low and extremely low birthweight (VLBW and ELBW) infants uniformly indicate dramatic decreases in the mortality and morbidity of these infants during the past 20 years.’,* The annual number of survivors of ELBW infants increased from 53 in 1986-87 to 84 in 1989-90 with improvement in the survival rates of 51.9% in 1986-87 to 68.8% in 1989-90 for infants born alive of birthweights 400-999 g at the Mater Mothers’ Hospital (MMH), Brisbane. The study of Tudehope ef aL3 presented a cost analysis for the care of ELBW infants for the years 1986 and 1987. This study has been widely quoted in Australia and elsewhere to cost noenatal intensive care and to provide a basis for funding purpose^.^ We feel it is important to present updated information on the cost per surviving ELBW infant because costs presented in the 1986-87 study may give a misleading impression of how expensive it is to keep an ELBW infant alive, particularly for the group of infants of birthweight less than 800 9. In 1989-90. of the 122 ELBW infants who were either live born at MMH or admitted to the Intensive Care Nursery 84 (68.8%) survived to hospital discharge compared with a survival rate of 51.9% (53 of 102) in 1986-87. The cost of establishing a new neonatal intensive care unit of 43 cots in an existing hospital with available floor space, including operating costs for an average year in the life of the unit, was estimated previously3 and this forms the basis of updating the costs for care in 1989-90. The average daily cost for each level of care was available from the previous study.3 Although the basic infrastructure of the unit remained unchanged, the additional costs of new equipment and increases in the medical and nursing staff salaries were added to the fixed and variable costs and the average cost of each level of patient care was updated. ELBW

infants were subdivided into 100 g birthweight strata and average cost of care for babies in each stratum was calculated separately for all babies and survivors. Days spent by ELBW infants in each level of care were obtained from the unit’s computer records. To enable a valid comparison of the real resources utilised all costs are expressed in 1987 Australian dollars for the years studied. Due to spectacular improvements in the survival rates for ELBW infants in the last 5 years the average cost per survivor decreased from $68 355 in 1986-87 to $56 707 in 1989-90. The most dramatic change in the average cost per survivor occurred for infants

Cost analysis of extremely low birthweight infants: an update.

J. Paediatr. Child Health (1992) 28, 410 Letter to the Editor 26 June 1992 Dear Editors COST ANALYSIS OF WTREMELY LOW BIRTHWEIGHT INFANTS: AN UPDATE...
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