Acute and Long-Term Healthcare Utilization and Expenditures for Serious Bacterial Infections among Newborns in US Hospitals

Abstract

Introduction: Serious bacterial infections among newborns are associated with significant morbidity, mortality, and economic costs. While most newborns fully recover following the acute phase of illness, some develop long-term complications that require medical care. The objective of this real-world study was to estimate acute and long-term healthcare utilization and expenditures among US newborns with bacterial meningitis or sepsis during their birth hospitalization. Methods: A retrospective matched-cohort design and a US healthcare claims database were employed. Study population comprised newborns who, during their birth hospitalization, had evidence of meningitis or sepsis due to a bacterial pathogen and matched comparison newborns. Study measures included all-cause healthcare utilization and expenditures during the birth hospitalization as well as the 1-year period following discharge. Results: Among newborns with bacterial meningitis (N = 678), 61% were born prematurely, 27% had low birthweight, and 56% had ≥ 1 high-risk condition; among those with bacterial sepsis (N = 33,478), corresponding values were 48%, 20%, and 33%. During the birth hospitalization, utilization and expenditures were higher (versus comparators) among newborns with meningitis (hospital days, 37 versus 23; intensive care unit [ICU], 97% versus 64%; expenditures, US $423,390 versus $168,861) and sepsis (hospital days, 18 versus 14; ICU, 93% versus 52%; expenditures, $139,973 versus $78,549). Mean levels during the 1-year follow-up period were also markedly higher (versus comparators) among newborns with meningitis (expenditures: by $218,464) or sepsis (expenditures: by $39,259). Conclusions: Serious bacterial infections among newborns place a substantial burden on the US healthcare system for the treatment of acute illness as well as long-term complications. Interventions targeting the prevention of newborn bacterial infections have the potential to yield significant resource utilization and cost offsets.