Examining the Relationship between Cost and Quality of Care in the Neonatal Intensive Care Unit and Beyond

Abstract

There is tremendous variation in costs of delivering health care, whether by country, hospital, or patient. However, the questions remain: what costs are reasonable? How does spending affect patient outcomes? We look to explore the relationship between cost and quality of care in adult, pediatric and neonatal literature. Health care stewardship initiatives attempt to address the issue of lowering costs while maintaining the same quality of care; but how do we define and deliver high value care to our patients? Ultimately, these questions remain challenging to tackle due to the heterogeneous definitions of cost and quality. Further standardization of these terms, as well as studying the variations of both costs and quality, may benefit future research on value in health care.

Keywords: health care costs; neonatal intensive care; quality; value.

Figure 1

Framework used to evaluate the association between cost and quality hospitals can be classified as high or low performers based on their costs and quality of care.

Figure 2

The neonatal value equation. Reproduced with permission from Pediatrics Vol. 137, Issue 3, e20150312. Copyright © 2016 by the American Academy of Pediatrics (AAP).

Figure 3

The relationship between quality improvement, outcomes, and costs.