Persistence of Morbidity and Cost Differences Between Late-Preterm and Term Infants During the First Year of Life

TLDR

Late‑preterm infants are known to experience higher morbidity and costs during the neonatal period, but it is unclear whether these differences persist beyond that time. This study aimed to assess the causes and costs of rehospitalization and other health‑care use in late‑preterm versus term infants during the first year and to explore strategies to reduce their morbidity and expenses. A retrospective cohort of 1,683 late‑preterm and 33,745 term infants born in 2004 was analyzed using a large national database, evaluating all health‑care services and costs from birth through one year of life. Late‑preterm infants had a longer birth stay (8.8 days vs 2.2 days), higher birth cost ($26,054 vs $2,061), and first‑year costs three times higher ($12,247 vs $4,069) than term infants, with rehospitalization rates of 15.2 % versus 7.9 % and especially high costs among those discharged late, indicating persistent greater morbidity and health‑care burden through the first year.

Abstract

Late-preterm infants are known to have greater morbidity and costs compared with term infants during the neonatal period, but less is known about whether these differences continue beyond this period.The purpose of this study was to examine the most common causes and costs of rehospitalization and other health care use among late-preterm and term infants throughout the first year of life.We conducted a retrospective cohort study of late-preterm (33-36 weeks' gestation) and term infants born in 2004 with > or =1 year of enrollment in a large national US database of commercially insured members. All of the reported health care services and costs were examined from the birth hospitalization through the first year of life.We evaluated 1683 late-preterm and 33 745 term infants. The average length of stay of the birth hospitalization for term infants was 2.2 days, and the average cost was $2061. Late-preterm infants had a substantially longer average stay of 8.8 days and average cost of $26 054. Total first-year costs after birth discharge were, on average, 3 times as high among late-preterm infants ($12 247) compared with term infants ($4069). Late-preterm infants were rehospitalized more often than term infants (15.2% vs 7.9%). A subset of late-preterm infants that were discharged late from their birth hospitalization had the highest rates of rehospitalization and total health care costs. Higher costs during rehospitalization of late-preterm infants, especially those with a late discharge, indicate their propensity to have more severe illness.Late-preterm infants have greater morbidity and total health care costs than term infants, and these differences persist throughout the first year of life. Management strategies and guidelines to reduce morbidity and costs in late-preterm infants should be investigated.