The cost of necrotizing enterocolitis in premature infants.

Necrotizing enterocolitis (NEC), a common morbidity of prematurity, affects 5-10% of premature infants with a birthweight <1500 g. The added cost remains unclear. Multiple studies report the cost of care for an infant with NEC as higher than that of well premature infants, but these studies are fraught with limitations. Surgical intervention and type of surgery appear to impact overall costs. Health care resource utilization extends beyond the birth hospitalization, particularly in those infants requiring surgery, and persists to at least three years of age. This narrative review of the literature reveals a paucity of studies and significant methodological deficiencies in most included studies. Further studies of the cost of NEC need to address the issues of significant confounding in this complex population.

[1]  J. Hay,et al.  Long term healthcare costs of infants who survived neonatal necrotizing enterocolitis: a retrospective longitudinal study among infants enrolled in Texas Medicaid , 2013, BMC Pediatrics.

[2]  J. Zupancic,et al.  Evidence, Quality, and Waste: Solving the Value Equation in Neonatology , 2016, Pediatrics.

[3]  D. Chang,et al.  Necrotizing Enterocolitis in 20 822 Infants: Analysis of Medical and Surgical Treatments , 2010, Clinical pediatrics.

[4]  D. Zelterman,et al.  Laparotomy versus peritoneal drainage for necrotizing enterocolitis and perforation. , 2006, The New England journal of medicine.

[5]  C. Berseth,et al.  Impact of necrotizing enterocolitis on length of stay and hospital charges in very low birth weight infants. , 2002, Pediatrics.

[6]  D. Spatz,et al.  Cost and Use of Pasteurized Donor Human Milk at a Children’s Hospital , 2017, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[7]  C. Weldon,et al.  Mortality of necrotizing enterocolitis expressed by birth weight categories. , 2009, Journal of pediatric surgery.

[8]  L. Arnold The Cost-effectiveness of Using Banked Donor Milk in the Neonatal Intensive Care Unit: Prevention of Necrotizing Enterocolitis , 2002, Journal of human lactation : official journal of International Lactation Consultant Association.

[9]  Katherine Carroll,et al.  The cost of using donor human milk in the NICU to achieve exclusively human milk feeding through 32 weeks postmenstrual age. , 2013, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[10]  T. Johnson,et al.  Cost Savings of Human Milk as a Strategy to Reduce the Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants , 2015, Neonatology.

[11]  E. Keeler,et al.  Outcomes and Costs of Surgical Treatments of Necrotizing Enterocolitis , 2015, Pediatrics.

[12]  T. Johnson,et al.  Cost of morbidities in very low birth weight infants. , 2013, The Journal of pediatrics.

[13]  J. Neu,et al.  Necrotizing enterocolitis. , 2011, The New England journal of medicine.

[14]  J. Thorp,et al.  Necrotizing Enterocolitis Among Neonates in the United States , 2003, Journal of Perinatology.

[15]  K. Simmer,et al.  Peritoneal drainage versus laparotomy as initial surgical treatment for perforated necrotizing enterocolitis or spontaneous intestinal perforation in preterm low birth weight infants. , 2011, The Cochrane database of systematic reviews.

[16]  T. Trikalinos,et al.  Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine. , 2016, JAMA.

[17]  J. Hay,et al.  Costs of necrotizing enterocolitis and cost-effectiveness of exclusively human milk-based products in feeding extremely premature infants. , 2012, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[18]  J. Zupancic,et al.  Cost-Effectiveness of Supplemental Donor Milk Versus Formula for Very Low Birth Weight Infants , 2018, Pediatrics.

[19]  J. Hodek,et al.  Measuring economic consequences of preterm birth - Methodological recommendations for the evaluation of personal burden on children and their caregivers , 2011, Health economics review.

[20]  Assuring Healthy Outcomes,et al.  Preterm Birth : Causes , Consequences , and Prevention , 2005 .

[21]  B. Vohr,et al.  Neurodevelopmental and Growth Outcomes of Extremely Low Birth Weight Infants After Necrotizing Enterocolitis , 2005, Pediatrics.

[22]  Karalee Poschman,et al.  Cost of Hospitalization for Preterm and Low Birth Weight Infants in the United States , 2007, Pediatrics.

[23]  R. L. Moss,et al.  Necrotizing enterocolitis: an update. , 2011, Seminars in fetal & neonatal medicine.

[24]  C. Lejeune,et al.  Economic analysis of the costs associated with prematurity from a literature review. , 2014, Public health.

[25]  Linh G. Ly,et al.  Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months: A Randomized Clinical Trial. , 2016, JAMA.

[26]  J. Zupancic,et al.  Prospective economic evaluation alongside the non-invasive ventilation trial , 2017, Journal of Perinatology.

[27]  S. Eaton,et al.  International Survey on the Management of Necrotizing Enterocolitis , 2014, European Journal of Pediatric Surgery.