Estimates of healthcare spending for preterm and low-birthweight infants in a commercially insured population: 2008-2016

Abstract

The growth in healthcare spending is an important topic in the United States, and preterm and low-birthweight infants have some of the highest healthcare expenditures of any patient population. We performed a retrospective cohort study of spending in this population using a large, national claims database of commercially insured individuals. A total of 763,566 infants with insurance coverage through Aetna, Inc. for the first 6 months of post-natal life were included, and received approximately $8.4 billion (2016 USD) in healthcare services. Infants with billing codes indicating preterm status (<37 weeks, n = 50,511) incurred medical expenditures of $76,153 on average, while low-birthweight status (<2500 g) was associated with average spending of $114,437. Infants born at 24 weeks gestation (n = 418) had the highest per infant average expenditures of $603,778. Understanding the drivers of variation in costs within gestational age and birthweight bands is an important target for future studies.

Fig. 1. 6-month spending distributions, stratified by gestational age.

The y-axis displays the gestational age group estimated from ICD-9/10 codes at birth and the x-axis displays the total 6-month expenditures in dollars.

Fig. 2. 6-month spending distributions, stratified by birthweight.

The y-axis displays the birthweight group estimated from ICD-9/10 codes at birth and the x-axis displays the total 6-month expenditures in dollars.