ABSTRACT

Objective: To evaluate the prevalence of chronic respiratory morbidity (CRM) in preterm infants (born ≤28 weeks gestational age (GA)) and compare healthcare resource utilization and costs among infants with/without CRM, and with/without bronchopulmonary dysplasia (BPD).

Methods: Commercial claims data from the Truven MarketScan database were retrospectively analyzed. Included infants were born ≤28 weeks GA and admitted to a neonatal intensive care unit (January 2009–June 2016). Continuous insurance eligibility was required from birth through 1 year (CRM/no CRM cohorts) or ≥3 months (BPD/no BPD cohorts) CA or death.

Results: CRM analysis included 1782 infants; 29.0% had CRM. BPD analysis included 2805 infants; 61.1% had BPD. The mean birth hospital length of stay was longer in infants with CRM versus those with no CRM (p < 0.0001). In infants with CRM or BPD, hospital readmission rates were significantly increased versus those without (both p < 0.0001). Total health care costs were significantly higher in infants with CRM (p = 0.0488) and BPD (p < 0.0001) versus those without. After birth hospitalization, outpatient visits and hospital readmissions accounted for most of the costs for the CRM and BPD cohorts.

Conclusion: CRM and BPD following extremely preterm birth impose a significant health care burden.

摘要

目的：评估早产儿（出生 ≤ 28 周胎龄（GA））慢性呼吸系统疾病（CRM）的患病率，并比较有/无 CRM 和有/无支气管肺发育不良（BPD）的婴儿的医疗资源利用和成本.

方法：对来自 Truven MarketScan 数据库的商业索赔数据进行回顾性分析。纳入的婴儿出生 GA ≤ 28 周并入住新生儿重症监护病房（2009 年 1 月至 2016 年 6 月）。从出生到 1 年（CRM/无 CRM 队列）或≥3 个月（BPD/无 BPD 队列）CA 或死亡需要连续保险资格。

结果：CRM 分析包括 1782 名婴儿；29.0% 有 CRM。BPD 分析包括 2805 名婴儿；61.1% 有 BPD。与没有 CRM 的婴儿相比，有 CRM 的婴儿的平均出生住院时间更长（p < 0.0001）。在患有 CRM 或 BPD 的婴儿中，再入院率与没有的婴儿相比显着增加（均 p < 0.0001）。有 CRM (p = 0.0488) 和 BPD (p < 0.0001) 的婴儿与没有的婴儿相比，总医疗保健成本显着更高。出生住院后，门诊就诊和再入院占 CRM 和 BPD 队列的大部分成本。

结论：极早产后的 CRM 和 BPD 给医疗保健带来了沉重的负担。