Treatment Costs for Very Low Birthweight Infants

The California Medicaid Experience

by Jeannette Rogowski, Ellen Harrison

Download

Download eBook for Free

FormatFile SizeNotes
PDF file 2.8 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

Purchase

Purchase Print Copy

 FormatList Price Price
Add to Cart Paperback67 pages $13.00 $10.40 20% Web Discount

This study, based on all very low birthweight (VLBW) single live births covered by the state of California's Medicaid program between the years 1984 and 1987, is the largest and most comprehensive to date of treatment costs for this high-risk infant group. Treatment costs and Medicaid expenditures are measured for the initial hospitalization and during the remainder of the first year of life. The study reconfirms the high-risk nature of these infants, with 33 percent of infants dying before the end of their first year of life. VLBW infants are also extremely expensive to care for, with treatment costs for the initial hospitalization averaging $54,900 (in 1987 constant dollars). Some infants have catastrophic expenditures; for instance, the average cost of the initial hospitalization for surviving infants with birthweights between 500 and 749 grams is $157,000. Medicaid expenditures for the care of VLBW infants are high, both because treatment costs are high and because the program pays for many of these births. Medicaid reimbursements do not cover treatment costs, however, creating a financial strain on the providers of their care. The authors conclude that policies that aim to reduce the incidence of VLBW births, such as encouraging prenatal care, have the potential to be extremely cost effective. Each VLBW birth avoided saves over $50,000 in the cost of the initial hospitalization. Significant savings can accrue with only minor gains in the birthweight of the infant. For instance, among surviving infants with the lowest birthweights (between 500 and 749 grams), an increase in weight at birth of only 500 grams results in a $90,000 cost savings during the initial hospitalization. The report will be of value to all persons interested in the treatment costs of VLBW infants and Medicaid expenditures for their care. It should be particularly useful to policymakers in quantifying the cost-effectiveness of prenatal care and other strategies aimed at improving birth outcomes.

This report is part of the RAND Corporation monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.