cost of low birth weight babies

This means that on average 904 low birth weight babies were born to residents of Contra Costa … 1/3 of the babies were admitted for observation. Through the comparison between DALYs due to the death of VLBW babies estimated in this study (257.44) and DALYs from all neonatal mortality in the area (836.68), it can be estimated that VLBW contributes to more than one third of the burden of neonatal mortality in the area. For more information about PLOS Subject Areas, click �7��0��!��p�! An increase in birth weight of 100 grams would lead to a 53% decrease in these costs. About seven in 100 babies born in the UK have a low birth weight (HSC PHA 2017, ISD Scotland 2017, NHS Digital 2017, Welsh Government 2017). Information on health provider costs was collected by interviewing clinical staff to illustrate routine health care and resources required to provide necessary health care for LBW babies at the MDH and MCH. Tables 1 and 2 show the input variables for the cost to the household and the health system, respectively. Approaches for the prevention and treatment of hip osteoarthritis (OA) remain limited. However, the number of hospital admissions differed significantly between LBW and non-LBW weight babies. In addition, the study assessed the burden of mortality associated with LBW as well as the relationship between weight at birth and costs of routine health care for the household. Iron and multivitamin supplementation were given for free at the pharmacy of the MDH. In some cases this is because they were born ahead of time, and these infants are commonly called premature babies. Survival of infants with low birthweight depends largely on how much the baby weighs at birth, with the smallest babies … DEFINITION:- 1.Preterm baby:- a)A baby born before 37 completed weeks of gestation calculating from the first day of LMP is defined as “preterm baby.” Fifty five caretakers of LBW babies were interviewed after hospital delivery, and another 32 at attendance to the routine weighing visit (Table 3). Medicaid is the largest payer for maternity care in the United States. These results are of relevance for similar settings and should serve to promote interventions aimed at improving maternal care. In this study the evaluation of the economic burden of LBW focus on short term costs and DALYs associated with LBW. Most caretakers were the infant's mother and the majority of them were housewives. https://doi.org/10.1371/journal.pone.0028744.g002. The number of required visits at the health facility (N) was estimated according to previous estimates of daily weight gain in LBW babies [39], using the following formula:Costs associated with outpatient visits and hospital admissions during the first year of life were estimated as the sample average cost of a hospital admission or of an outpatient attendance. The only study carried out in this region reported that the costs of hospital care for VLBW infants were very high for the health system [30]. About 6% of all babies are estimated to be born with a low birth weight. Therefore, the average costs associated with each non-LBW baby is US$ 121 (17.28+17.28*6). << Preterm/low birth weight infant hospital stays have an average cost of $15,000 and an average length of 12 days, versus $600 and 1.9 days for full-term, normal birth weight babies. While some long term LBW costs estimates have been undertaken in high-income countries [55], these are extremely scarce in low-income countries [56]. We observed a gender imbalance, being 69% of LBW babies females and 31% males. Costs incurred by the households were collected through exit surveys. Probabilistic sensitivity analysis (Monte Carlo simulation) was carried out to allow for uncertainty around cost estimates (Tables 1 and 2). The average number of days admitted to the MDH and the average number of routine weighing visits were 3.44 and 2.13, respectively. LBW, defined by the World Health Organization (WHO) as weight at birth of less than 2.5 kg irrespective of gestational age, has adverse consequences on infant survival and physical and cognitive development [2], [3]. Analyzed the data: ES. However, it can be speculated that if such costs were considered, the economic burden of LBW would be much higher. PLoS ONE 6(12): Affiliations However, the aim of the estimated regression between household costs and weight at birth was not to assess the existence of a relationship but rather to measure, through univariate analysis, the magnitude of such a relationship. There were 172 patients with LBW babies out of 1517 patient. Copyright: © 2011 Sicuri et al. Costs were highest for extremely preterm infants (<28 weeks’ gestation/birth weight <1000 g), averaging … Two sources of incremental cost were identified for LBW compared to non-LBW weight babies during the first year of life, i.e., costs for routine health care (incremental days of admission after hospital delivery and weighing visits) and costs for excess morbidity (hospital admissions and outpatient attendances). In the United States it has been estimated that the expected costs of delivery and initial care of a baby weighing 1000 g at birth can exceed $100 000 , however, there are no documented estimates of costs of care for LBW/VLBW (very low birth weight) in sub-Saharan Africa. costs associated with the 3.5–4 million children aged 0 to 15 born at low birth weight was$5.5–6billionmorethanifthechildrenhadbeenbornatnormalweight,andthat LBW accounted for 10 percent of all health care costs for children. In 2017, Japan had the highest proportion of low birth weight babies with 9.4% and Finland had the lowest with 4.2%. In 50 … Forty six caretakers of babies born with LBW were identified and interviewed at the time of hospital discharge or at outpatient attendance for an acute illness episode. Costs per bed/day at the MCH were estimated to be 3 times higher than at the MDH because of higher availability and use of resources in this tertiary health facility. Only one previous study in Africa made an assessment of the economic costs associated with LBW [30]. What does low birth weight mean? stream Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain, This study aimed at estimating the costs of health care of LBW babies for the health system and the household during the first year of life in a rural area of Southern Mozambique. Both for routine health care (incremental days of admission after hospital delivery and weighing visits) and excess morbidity (hospital admissions and outpatient attendances), direct and indirect costs for LBW were estimated. Health system costs during infancy associated with LBW babies among the 3,322 live births occurred in the study area during the year 2007 were almost 4 times higher than the average yearly national public health expenditure for the Expanded Programme on Immunization budgeted for the period 2007–2012, also calculated for a target of 3,322 live births [49]. Household cost distribution for routine health care appeared positively skewed, with one high value of 156.86 US$ (which included the cost of referral to the tertiary hospital), while the majority of the estimated costs were concentrated around similar lower values. For instance, non-LBW term newborns with an eutocic delivery are admitted less than 24 hours (cost of 1 bed/day from Table 2 = US$ 17.28) and, on average, 0.7 times during the first year of life for an average 6 nights (US$17.28*6). %PDF-1.3 Costs associated with LBW excess morbidity were calculated on the incremental number of hospital admissions in LBW babies compared to non-LBW weight babies. Infant and neonatal mortality rates for 2005–2006 in the area were 75 and 26 per 1000 live births, respectively (Nhacolo A., personal communication). >> Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain, The results of the present study highlight the fact that costs associated with LBW are not restricted to those of sophisticated hospital care provided to VLBW babies. Excluding deaths, 93.1% of non-LBW weight babies and 95.5% of LBW babies attended the MDH as outpatients at least once [Chi2(17) = 11.00; p = 0.856]. Increasingly, global efforts are being deployed to improve child survival, a key target of the Millennium Development Goals (MDGs) [20], [21], and LBW is a well known contributor to neonatal and infant mortality [8], [22]. Manhiça Health Research Centre (CISM), Manhiça, Mozambique, Affiliation The climate is subtropical with a warm and rainy season between November and April, and a cool and dry season during the rest of the year. The study was approved by the National Mozambican Ethics Review Committee and the Hospital Clinic of Barcelona Ethics Review Committee. The reason behind this choice is related to the difficulties of estimating the economic value of lost lives [54]. We also thank Kara Hanson and Eve Worrall for their extremely useful comments. What Is Considered As Low Birth Weight In Babies? Low birth weight babies need to receive enough nutrition to grow in the NICU at about the rate they would have if they had stayed in the uterus. Manhiça Health Research Centre (CISM), Manhiça, Mozambique. Mean birth weight was 2.26 kg, and 69% were females. Nearly all low birthweight babies need specialized care in the Neonatal Intensive Care Unit (NICU) until they gain weight and are well enough to go home. Cost analysis studies too reflected changes of cost in (inverse) relation to birth weight and this includes a local study by Cheah et al. Low birth weight (LBW), defined as a birth weight <2500 g, remains a significant public health problem in many parts of the world and is associated with a range of both short- and long-term adverse consequences. Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain, Affiliations Accessed February 24, 2021. What causes low birthweight? Considering 3,322 live births, the overall DALYs due to LBW in the study area were 2,746.06. Thus, the average cost per LBW baby is US$ 546 (425+121), 4.5 times higher than the cost per non-LBW baby. 54 0 obj How much does premature birth cost society? Yes Click through the PLOS taxonomy to find articles in your field. Most of these deaths occur during the neonatal period when the risk of death is six times higher than in high-income countries [6]–[8]. The association between household costs for routine health care and weight at birth is represented by the following equation: Log (household costs) = 13.58–5.30*weight at birth. Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain, This study aims to estimate the costs to the health system and to the household and the Disability Adjusted Life Years (DALYs) arising from infant deaths associated with LBW in Southern Mozambique. 1 Babies born weighing less than 2,500 grams or 5 lbs. To our knowledge, this is the first economic evaluation of the costs associated with LBW in rural areas of low-income countries, and shows that LBW carries a significant economic burden both for the health system as well as for the families. Incremental hospital admission costs due to excess morbidity during the first year of life were 11,612.16 US$ (CI 95% 10,002.00; 13,221.00). Objective: To test the hypothesis that parental stress associated with long-term morbidity of very low-birth-weight infants (VLBWIs) is long lasting. Infants born with LBW have added health risks which require close management, often in a neonatal intensive care unit (NICU). Currently, about one in twelve babies are born with a low birth weight. A range of ±25% was used to represent variability around mean values. which reported that the total cost per infant ranged from $26 to $3818 for babies between 1000-1500kg (1999 data and cost values) . Wrote the paper: ES AB CM. Costs to the health system arising from routine care provided to LBW babies were calculated with reference to a target of 1000 live births at the MDH, assuming 12% and 1% of LBW and VLBW respectively in the area ([35], Nhacolo A, personal communication). Setting: High-risk newborn follow-up program, Winnipeg, Manitoba. Preterm/low birth weight infant stays averaged $15100, with a mean length of stay of 12.9 days versus $600 and 1.9 days for uncomplicated newborns. Unit costs were obtained from previous estimates and data provided by the administration department of the MDH [34]. Household costs were not calculated directly from the study sample. However, family members of a low birth rate baby need to be extra vigilant to ensure the child stays healthy. Years of Life with Disability (YLDs), for the first weeks of life, were included in DALYs calculation, applying a duration disability of 2 to 21 days (uniform distribution) and a disability weight of 0.256 for treated low birth weight sequelae. For instance, the use of point of care diagnostic tests at the ANC, followed by adequate treatment, against frequent causes of LBW, is likely to have an impact decreasing this burden. which reported that the total cost per infant ranged from $26 to $3818 for babies between 1000-1500kg (1999 data and cost … In low-income countries about 60% of all infant deaths are reported in LBW babies [5]. 8oz. here. Yes … MR.SACHIN GADADE M.SC(N) PEDIATRICS LOW BIRTHLOW BIRTH WEIGHT BABIESWEIGHT BABIES 2. More than twenty million low birth weight (LBW) babies are born every year in low-income countries [1]. The cost of iron and multivitamin supplementation was added to this estimate [42]. The relationship between total household cost and birthweight was estimated using a log-linear regression model. Costs for premature and low-birth-weight babies are also higher in terms of combined medical costs for the mother and child -- $64,713, compared with $15,047 for … A round-the-clock hospital-based clinical surveillance system has been operating in the area since 1997 and has been described in detail elsewhere [33]. The study found that the majority of babies weighed below 2.5 kilos (5lbs, 8oz) at birth. Low birth weight is defined by the World Health Organization (WHO) as weight at birth less than 2500 g (5.5 lb). Direct and indirect household costs for routine health care were 24.12 US$ (CI 95% 21.51; 26.26). • Contra Costa’s percentage of low birth weight babies did not meet the Healthy People 2010 objective. Costs associated with LBW excess morbidity were calculated on the incremental number of hospital admissions in LBW babies compared to non-LBW weight babies. Information on birthweight was registered for 990 of them (98.6%), and of these 117 were LBW babies (12%) [36]. We thank the staff of the Manhiça District Hospital, especially those at the maternity clinic and at the administration department, and the staff of the Manhiça Health Research Center (CISM). Information on household costs for LBW babies was collected between July and November 2007 at the MDH through exit survey. Gave explanations, comments, and suggestions on various aspects of the study and of the study area: AB BS AN DN EM PLA. No, Is the Subject Area "Health economics" applicable to this article? Applied to the target population of 1000 newborns considered in the analysis, it was estimated that 8 out of 10 VLBW and 17 out of 110 LBW would die during the first year of life. Any measure of mortality or morbidity burden caused by LBW should include the long term disability associated with this health status at birth. The two main causes of hospital admission were respiratory infections and malaria, representing 33.3% and 27.0% of all admissions in the sample. Why some babies have low weight at the time of birth is explained below. broad scope, and wide readership – a perfect fit for your research every time. Very low birth weight (VLBW) babies, defined as weighing 1.5 kg or less at birth, have a high risk of death and disease during the first year of life [4]. Design: Matched case-control study. In addition, the care of LBW babies represents an enormous burden for families and health systems, which may be particularly relevant in low-income countries because of the already stressed weak health systems. One of the known causes of this condition is premature birth. In brief, all children attending the paediatric department are seen by project health personnel who administer a detailed standardized clinical and demographic questionnaire that documents signs and symptoms including birth weight. Infant birth weight is a common measure of infant and maternal health and well-being. The extraordinary cost of managing the medical, educational, and social needs of extremely low-birth-weight newborns, as well as term newborns with perinatal asphyxia, often are not discussed with parents early in the infant's care. About one in 15 babies who are born in Australia have a low birth weight (AIHW 2020). https://doi.org/10.1371/journal.pone.0028744.t001, https://doi.org/10.1371/journal.pone.0028744.t002. https://doi.org/10.1371/journal.pone.0028744.t003. On the other hand, welfare losses borne by caretakers without a formal and remunerated occupation (housewives) were conservatively estimated by multiplying the amount of time spent away from their main activity because of child's illness times the average national minimum statutory monthly wage in force in Mozambique at the time of the study (37 US$) [40]. If your baby is born between 37 to 42 weeks of pregnancy and weighs around 5 pounds (2.5 kgs) or less, then he is considered to be of low birth weight. We are very grateful to the babies and their caretakers who participated in the study. Poisson regression model was used to quantify the incremental number of visits or admissions experienced by LBW compared to non-LBW weight babies only after assessing their statistical significance. e28744. |�t`H*�8��Z��)Z�+鄪�༗��1��0�PޠT��Z�� FjQ}dbۥu�7 Low birth weight (LBW) is the medical classification for a baby who weighs less than 2500 gramsor 5 lbs 5 ozat birth. Including the 9 twin babies, there were total 181 babies with LBW. A baby is considered underweight when they are born weighing less than 2,500 grams (5 pounds, 8 ounces). LBW has been associated with an increased risk of respiratory and diarrhoeal disease [9]–[11], impaired growth and mental development, and poor outcomes in young adulthood [12]–[15]. Adjacent to the CISM is the Manhiça District Hospital (MDH), a 110 bed health facility, which provides preventive and curative services. Geographical and demographic characteristics of the area have been described elsewhere [32]. However, that number has greatly decreased due to advancements made in pre… The mean value of household cost, both direct and indirect, associated with routine health care for a LBW baby was 23.04 US$. National Institute of Health and National Directorate of Health, Ministry of Health, Maputo, Mozambique, Affiliations Conceived and designed the experiments: ES CM. Knowledge of such a variation would assist scaling up LBW-related health interventions in the whole country. The primary cause is premature birth, being born before 37 weeks gestation; a baby born early has less time in the mother's uterus to grow and gain weight, and much of a fetus's weight is gained during the latter part of the mother's pregnancy.. Another cause of low birthweight is intrauterine growth restriction. After hospital delivery, mothers of babies with weight at birth ≤2 kg are trained on kangaroo mother care (KMC) techniques [38]. Further research, possibly cohort studies, should focus on the long term economic and health impact of LBW in low income areas in which lifelong disabilities are likely to impose a huge toll particularly on the households, as a consequence of fragile health systems lacking appropriate resources to manage chronic health impairments. Incremental costs of admission due to LBW after hospital delivery at the referral tertiary hospital and at the MDH were 29,937.60 US$ (CI 95% 21,830.00; 38,760.00) and 4,145.43 US$ (CI 95% 2,130.00; 6,360.00), respectively. Differences by state do not take into account other state specific population characteristics that may affect the level of the birth … https://doi.org/10.1371/journal.pone.0028744.g001. Eighty percent of pregnant women in this area have institutional delivery (Nhacolo A, personal communication). The only newborn transferred to the MCH was admitted for 17 days before dying. H�lW�rۺ}�W��W$E�j:��$N;+�s'�DA�PЊ��oz��k��].H�v2��X@K`�{�zq��d��d2��O�N�4��Q>O,vg��o��ƂeQ��g_�Ż��|O��7�n��x��O�[�?��i��t��:��?+�g�Q2��eZ��c��}��Ӵ�˲�N=_ K�Y�L^.v��t��2ϓQ��{��e�,�O=��׼�N��_dYϣK܃�tgy:=]�ݫ__D8�O�s�Ӣw;ٺt��l~��ꗛ��HN��F_ݾ�n9��ɢ��~�}�$�t^�K�ֻՇ�H��ʸ-��T��c�ݾ~|:g��h�e*��Q��$[�|�&��u��hVW�V��N6N��A�k^�3�k�R�U[;%��I�� Incremental costs associated with excess morbidity were thus calculated only on hospital admissions, based on one additional episode of admission for LBW compared to non-LBW weight babies. https://doi.org/10.1371/journal.pone.0028744.t004. What is Considered a Low Birth Weight in a Baby? "Percentage of infants with low birth weight in the United States as of 2018, by state*." In the health economics literature, the long term economic burden is usually measured considering costs associated with the lower educational and productive outcomes that are usually associated with LBW later in life. The unit of analysis of costs associated with routine health care was the LBW baby. While there is wide evidence on costs associated with LBW in high-income countries [23]–[27], data on economic implications of care of LBW babies are scarce for middle-income countries [28], [29], and almost nonexistent for Sub-Saharan Africa. This imbalance may be explained by the significant association between female gender and LBW observed among newborns in the area, and by the existence of a trend towards increased neonatal mortality among male LBW babies compared to female LBW babies [51]. No, Is the Subject Area "Body weight" applicable to this article? HIV infection, malaria, malnutrition, and anaemia during pregnancy along with maternal younger age have been reported to be risk factors for LBW [16]–[19]. All LBW babies receive iron supplementation and multivitamins for 3 months [37]. https://doi.org/10.1371/journal.pone.0028744, Editor: Josef Neu, University of Florida, United States of America, Received: July 26, 2011; Accepted: November 14, 2011; Published: December 12, 2011. Experiences during this time can have life-long effects on intellectual, emotional, and social functioning. The main economic activities are subsistence farming and sugarcane and fruit processing. For premature and/or low birth weight babies (less than 37 weeks gestation and/or less than 2500 grams), the average cost was $55,393, of which $54,149 was paid by the health plan. Health system costs for routine health care of LBW babies were calculated as the sum of costs of incremental hospital admission days after delivery and weighing visits. Funding: Elisa Sicuri is supported by a grant from the MiP Consortium, which is funded through a grant from the Bill & Melinda Gates Foundation to the Liverpool School of Tropical Medicine, and by a CIBERESP (Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica) fellowship. This has the potential to change the current paradigm of hip osteoarthritis prevention by targeting early life factors. Health system costs associated with LBW for the live births occurred during the year 2007 in the study area (N = 3,322) were 169,957.61 (CI 95% 144,900.00; 195,500.00). For more information about PLOS Subject Areas, click While incremental costs associated with LBW were presented for two cohorts of 1000 and 3,322 babies, it is important to mention the average costs both per LBW and non-LBW babies. "��i��i��$Eh%#(�Mp�j�tk�c?�[��q��n6��:L�j�� The first three years of life are critically important for a childs brain development. INTRODUCTION. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0028744. Being the estimated cost associated with LBW for a target of 1000 live births US$ 50,953.68 and considering that 120 babies out of 1000 are of LBW, the incremental cost per LBW baby is, on average, US$ 425 (50,953.68/120). In order to measure costs incurred by the households, caretakers of LBW babies were invited to participate in the survey when leaving the hospital and if informed consent was signed a standardised questionnaire was administered. December 13, 2018. There was no statistically significant difference in the number of outpatient attendances between LBW and non-LBW weight babies during the first year of life. Direct and indirect household costs for routine health care were 24.12 US$ (CI 95% 21.51; 26.26). Direct and indirect household costs for hospital admissions were 8.50 US$ (CI 95% 6.33; 10.72). All costs were confirmed with the administrative staff of the MDH and updated to 2007 levels using the average annual rate of inflation [41].