Economics of Home Monitoring for Apnea in Late Preterm Infants.
Respir Care
; 62(1): 42-48, 2017 Jan.
Article
en En
| MEDLINE
| ID: mdl-28003553
ABSTRACT
BACKGROUND:
Apnea of prematurity affects a small proportion but large absolute number of late preterm infants, with out-patient management variably utilized despite relative clinical equipoise and potential for improved cost-effectiveness.METHODS:
Over a 5-y period, from 2009 to 2013, infants born at ≥34 weeks gestational age at a level IIIB academic center in Boston, Massachusetts, with discharge-delaying apnea, bradycardia, and desaturation (ABD) events were identified. In-patient costs for discharge-delaying ABD events were compared with hypothetical out-patient management. Out-patient costs took into account 4-10 d of in-patient observation for ABD events before caffeine initiation, 3-5 d of additional in-patient observation before discharge, daily caffeine until 43 weeks corrected gestational age, home pulse oximetry monitoring until 44 weeks corrected gestational age, and consideration of variable readmission rates ranging from 0 to 10%.RESULTS:
A total of 425 late preterm and term infants were included in our analysis. Utilization of hypothetical out-patient management resulted in cost savings per eligible patient ranging from $2,422 to $62, dependent upon variable periods of in-patient observation. Sensitivity analysis demonstrated few instances of decreased relative cost-effectiveness.CONCLUSIONS:
Out-patient management of discharge-delaying ABD events in a late preterm and term population was a cost-effective alternative to prolonged in-patient observation.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Apnea
/
Recien Nacido Prematuro
/
Costos de la Atención en Salud
/
Monitoreo Ambulatorio
/
Atención Ambulatoria
/
Tiempo de Internación
Tipo de estudio:
Health_economic_evaluation
/
Prognostic_studies
Límite:
Humans
/
Infant
/
Newborn
Idioma:
En
Revista:
Respir Care
Año:
2017
Tipo del documento:
Article