Prevalence of chronic respiratory morbidity, length of stay, inpatient readmissions, and costs among extremely preterm infants with bronchopulmonary dysplasia

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.

KEYWORDS:

• Extremely preterm
• bronchopulmonary dysplasia
• claims analysis
• health care costs
• chronic respiratory morbidity

Acknowledgments

Under direction of the authors, Nasser Malik, an employee of Excel Scientific Solutions, provided writing assistance for this manuscript. Editorial assistance in formatting, proofreading, and copy editing also was provided by Excel Scientific Solutions. Writing and editorial support were funded by Takeda.

Declaration of interest

ME Mowitz was a paid consultant to Shire, a Takeda company, in relation to this study. L Han is an employee of and holds stock/stock options in Shire, a Takeda company. R Ayyagari, W Gao, J Wang, and J Zhao are employees of Analysis Group, Inc., who were paid consultants to Shire in relation to this study. A Mangili and SP Sarda were employees of Shire, a Takeda company, at the time of the study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

All authors made substantial contributions to study conception and design, acquisition of data, or analysis and interpretation of data; participated in revising this manuscript critically for important intellectual content; and gave final approval of the version to be published.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This study was funded by Shire Development LLC and International Affiliates, Wayne, PA, a member of the Takeda group of companies.