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- Title
The neonatal costs of maternal cocaine use.
- Authors
Phibbs, C S; Bateman, D A; Schwartz, R M
- Abstract
<bold>Objective: </bold>--To examine the added neonatal cost and length of hospital stay associated with fetal cocaine exposure.<bold>Design: </bold>--All cocaine-exposed infants in the study population (n = 355) were compared with a random sample of unexposed infants (n = 199). Regression analysis was used to control for the independent effects of maternal age, smoking, alcohol consumption, prenatal care, race, gravidity, and sex of the infant.<bold>Setting: </bold>--A large, public, inner-city hospital studied from 1985 to 1986.<bold>Patients: </bold>--All infants were routinely tested for illicit substances, records were reviewed for maternal histories of substance abuse, and all known cocaine-exposed singleton infants were included.<bold>Main Outcome Measures: </bold>--Cost and length of stay until each infant was medically cleared for hospital discharge and cost and length of stay until each infant was actually discharged from the hospital.<bold>Results: </bold>--Neonatal hospital costs until medically cleared for discharge were $5200 more for cocaine-exposed infants than for unexposed infants (a difference of $7957 vs $2757 [P = .003]). The costs of infants remaining in the nursery while awaiting home and social evaluation or foster care placement increased this difference by more than $3500 (P less than .0001). Compared with other forms of cocaine, fetal exposure to crack was associated with much larger cost increases ($6735 vs $1226). Exposure to other illicit substances in addition to cocaine was also associated with much larger cost increases ($8450 vs $1283).<bold>Conclusions: </bold>--At the national level, we estimate that these individual medical costs add up to about $500 million. The large magnitude of these costs indicates that effective treatment programs for maternal cocaine abusers could yield savings within their first year of operation.
- Subjects
NEW York (State); COCAINE; COMPARATIVE studies; HOSPITAL utilization; LENGTH of stay in hospitals; MATERNAL age; NEONATAL diseases; MATERNAL-fetal exchange; RESEARCH methodology; MEDICAL cooperation; NEONATAL intensive care; REGRESSION analysis; RESEARCH; RESEARCH funding; SUBSTANCE abuse; URBAN hospitals; COST analysis; EVALUATION research; NEONATAL intensive care units; DISEASE complications; ECONOMICS; THERAPEUTICS
- Publication
JAMA: Journal of the American Medical Association, 1991, Vol 266, Issue 11, p1521
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.266.11.1521