PEDIATRICS Vol. 109 No. 3 March 2002, pp. 423-428
Impact of Necrotizing Enterocolitis on Length of Stay and Hospital Charges
in Very Low Birth Weight Infants
Jennifer A. Bisquera, MD, Timothy R. Cooper, MD and Carol Lynn Berseth, MD
Department of Pediatrics, Section of Neonatology, Baylor College of
Medicine, Houston, Texas
Objective. To determine the impact of necrotizing enterocolitis (NEC) on
length of stay and hospital charges.
Design. Case-control study.
Setting. Two neonatal intensive care units in an academic medical center.
Patients. Infants born in 1992-1994 with birth weight <1500 g, matched by
gestational age, hospital, and month of birth.
Measurements and Main Results. We performed odds ratio and t testing. As
with previous studies, there was no single factor that increased the risk
for developing NEC. However, the diagnosis of NEC increased the risk for
death, infection, and the need for central line placement. Infants with
surgical NEC had lengths of stay that exceeded those of controls by 60 days,
whereas lengths of stay among infants with medical NEC exceeded those of
controls by 22 days. Based on length of stay, the estimated total hospital
charges for infants with surgical NEC averaged $186 200 in excess of those
for controls and $73 700 more for infants with medical NEC. The yearly
additional hospital charges for NEC were $6.5 million or $216 666 per
survivor.
Conclusions. A diagnosis of NEC in the very low birth weight infant imposes
a significant additional financial burden to the individual patient as well
as the neonatal community as a whole. This expense justifies additional
research into preventive measures and potentially costly therapies aimed at
reducing the incidence of NEC. These data also provide an estimated cost to
compare the cost effectiveness of new preventive measures for NEC.
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