An Update on the Burden of Neonatal Abstinence Syndrome in the United States

Abstract

Objectives: To provide an estimate on the most recent burden of neonatal abstinence syndrome (NAS) in the United States.

Methods: The 2016 Kids' Inpatient Database, provided by the Healthcare Cost and Utilization Project and Agency for Healthcare Research and Quality and its partners, was used to identify patients with NAS in the United States. The data consisted of pediatric admissions from 4200 US hospitals recorded between January 1, 2016, and December 31, 2016. Data were converted to weighted form to project a national estimate on the possible number of neonates affected by NAS. Differences in sex, race, location, household income, primary payer form, length of stay, and total charges were studied.

Results: The sample contained 32 128 patients with NAS (0.8%), among whom 17 164 (53.5%) were boys and 14 935 (46.5%) were girls (P < .001); 23 027 (80.4%) were white (P < .001), and 13 583 (42.3%) were from the southern parts of the United States (P < .001). Medicaid covered 83.8% of patients, and 40.2% had an income within the first quartile of national averages (P < .001). The overall mean and median length of stay were 16.45 and 12.00 days, respectively, and the mean and median total charges were calculated as $79 937.75 and $38 537.00, respectively. The total charges of NAS were $2 549 098 822.

Conclusions: The incidence of NAS is on a constant rise; the number of cases rose from 21 732 in 2012 to 32 128 in 2016. Hospital charges have also tripled over the last 7 years to $2.5 billion in 2016.