• Viena Tommiska, Risto Tuominen, and Vineta Fellman.
• Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. viena.tommiska@stakes.fi
• Pediatr Crit Care Me. 2003 Apr 1;4(2):157-63.

ObjectiveTo assess the 2-yr costs of extremely low birthweight infants' (ELBWIs; birthweight, < 1000 g) care in relation to birthweight, outcome, and the costs of normal birthweight infants.DesignCost data were obtained from care-giving hospitals and by a parental questionnaire. Outcome data from the perinatal and neonatal periods and from the first 2 yrs for both ELBWIs and control infants had been prospectively collected to a national ELBWI register.PatientsWe studied 71 ELBWIs and 60 normal birthweight controls born in Helsinki University Hospital in 1996-1997.MeasurementsCollected data comprised costs resulting from care of ELBWIs and normal birthweight control infants and included hospital, outpatient care, medication, rehabilitation, auxiliary means, and travel costs; ancillary costs from daily care; parent's accommodation during hospitalization periods; and loss of earnings during the infant's first 2 yrs.Main ResultsThe average total 2-yr healthcare cost was 104,635 Euros for surviving ELBWIs and 3,135 Euros for control infants. In ELBWIs, initial hospital costs alone accounted for 64% of total costs; the costs during the first and second postdischarge years accounted for 20% and 13%, respectively. The mean hospital cost of nonsurviving ELBWIs was 19,950 Euros. A normally developed ELBWI had costs 25-fold, a mildly disabled ELBWI had costs 33-fold, and a severely disabled ELBWI had costs 68-fold those of control infants. Birthweight correlated negatively with intensive care costs but did not correlate with costs after initial discharge.ConclusionTotal costs of ELBWIs decreased over time up to the age of 2 yrs, but even in normally developed ELBWIs, costs remained higher than those of normal birthweight infants. Low birthweight seemed to be related to increased initial hospital costs but not to annual costs after the first discharge.

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