Evaluation of hospitalization costs and associated factors among maternity stays involving low-risk and moderate- to high-risk childbirths in the United States

ABSTRACT

Objectives: This study aimed to assess the costs of childbirth and to identify factors associated with such hospital costs for low- and moderate/high-risk childbirth groups.

Methods: All hospitalizations for childbirth between 2010–2014 in the Premier Perspective Hospital Database were identified. Risk category for each birth was defined by the age of the subject and/or presence of specific maternal comorbidities and obstetric risk factors. Hospital childbirth costs were determined and stratified by risk groups. Factors associated with costs for each risk group were evaluated by multiple regression.

Results: Among 2,367,195 hospitalizations for childbirth, vaginal birth was the most common delivery method (n = 1,596,757; 68%). Among women characterized as moderate/high-risk, 42% (n = 642,495) had C-sections, while 11% (n = 90,211) of women categorized as low-risk had C-sections. The proportion of women with serious maternal morbidity among moderate/high-risk vs. low-risk women was 2% (n = 29,496) vs. 0.3% (n = 2749), respectively. The mean costs for moderate/high-risk vs. low-risk hospitalizations were $6145 (median = $5760) and $5397 (median = $5001), respectively (p < 0.0001). Factors significantly associated with costs for moderate/high-risk hospitalizations included delivery type (C-section vs. vaginal birth), LOS, urban/rural hospital status, geographic regions, calendar year of hospitalization, teaching status, payer types and serious maternal morbidity. Similar factors were found to impact costs among low-risk hospitalizations.

Conclusions: Characteristics such as delivery type, LOS, geographical region, teaching status, serious maternal morbidity and hospital urban/rural status were shown to impact hospital costs of childbirth. Screening and prevention strategies of factors that negatively impact costs may aid in reducing the hospitalization costs associated with childbirths.

KEYWORDS:

• Hospitalization costs
• maternity stays
• childbirths
• high-risk childbirths
• low-risk childbirths
• moderate-risk childbirths

Declaration of interest

A Law, W Lin, and R Lynen are employees of Bayer HealthCare Pharmaceuticals Inc. J Yu is a former employee of Bayer HealthCare Pharmaceuticals Inc. J Lin is an employee of Novosys Health and served as a paid consultant to Bayer HealthCare Pharmaceuticals Inc. for this study and the development of this manuscript. 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.

Authors’ contributions

A Law, J Yu, and R Lynen were involved in the conception and design, analysis and interpretation of the data; W Lin was involved in the design, analysis and interpretation of the data; J Lin was involved in the analysis and interpretation of the data; all authors were involved in the drafting of the paper, revising it critically for intellectual content and the final approval of the version to be published. All authors agree to be accountable for all aspects of the work.

Previous presentations

This data has been presented at the 61^st American Society of Health-System Pharmacists Midyear Meeting (2016).

Supplemental data

Supplemental data for this article can be accessed here.

Additional information

Funding

This research was supported by Bayer HealthCare Pharmaceuticals Inc.