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Clinical Pediatrics
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Article

Variations in Costs for the Care of Low-Birth-Weight Infants Among Academic Hospitals

Henry G. Herrod, MD*, Cyril F. Chang, and Stephanie S. Steinberg

* To whom correspondence should be addressed. E-mail: hherrod{at}theurbanchildinstitute.org.


  Abstract
Objectives: To determine the relative role that academic hospitals (AHs) play in providing neonatal care for low-birthweight infants within a single state and to determine if there are variations in inpatient costs for neonatal services among AHs. Design: Retrospective analysis of hospital costs for low-birth-weight infants. Setting: Cases were identified using 2003-2005 data from the Tennessee Hospital Discharge Data System.A specific focus was discharge data from the 5 AHs that support obstetrical residencies and have a neonatal intensive care unit. Participants: Cases included all discharged infants with a birth weight of <2500 grams. Results: The 5 AHs discharged 18% of the total normal-birth-weight infants and 30% of the low-birth-weight infants for the entire state.AHs had higher costs associated with these infants than did other hospitals, with a single exception The difference in costs at this hospital was consistent with the finding of lower utilization rates of hospital services, a shorter average length of stay, and lower costs for infants insured by the state Medicaid program. Conclusion: Academic obstetrical hospitals discharged a disproportionately high percentage of low-birth-weight infants compared with other Tennessee hospitals.The lower costs observed in the Shelby County hospital indicates that other hospitals could potentially lower their costs for the care of low-birth-weight infants.

First published on July 30, 2009
Clinical Pediatrics 2009, doi:10.1177/0009922809341750
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