Cost Of Intensive Care For Prematures In Jordan Hospital: An Example from A Developing Country

1. Cost Of Intensive Care For Prematures In Jordan Hospital: An Example from A Developing Country Y K Abu-Osba, R A Jarad, D A Al-Masri, K H Zaineddeen Neonatal Intensive Care Unit Jordan Hospital, Amman, Jordan

2. Cost Of Intensive Care For Prematures In Jordan Hospital: An Example from A Developing Country Public Health Is Purchasable Within Natural Limitations. Any community can determine its own death rate.

3. Cost Of Intensive Care For Prematures In Jordan Hospital: An Example from A Developing CountryAim of the Study • To determine survival rate, care cost and complications of all admissions in a modern, well equipped and well staffed Neonatal Intensive Care Unit in a developing country. • To provide information for health care planners . • To provide practical real information for the parents regarding mortality, morbidity and cost.

4. Cost of Neonatal Intensive CareMajor Cost Elements Cost for the care for premature and sick newborns include: • Charges for the patient during hospitalization. • Cost for work loss and expenses for the family related to hospitalization of the baby and caring for post discharge. • Long term charges to care for and treat the possible complications.

5. Cost of Neonatal Intensive CareMajor Neurodevelopmental Sequelae of Prematures Major complications which may be evident at 1-2 years of age: • Cerebral palsy • Developmental retardation • Sensorineural hearing loss • Blindness • Hydrocephalus

6. Cost of Neonatal Intensive CareIncidence ofMajor Neurodevelopmental Sequelae of Prematures • Infants weighing < 1,500 gm ranges from 5% to 10%. • Infants weighing < 1,000 gm ranges from 10% to 20%. • Infants weighing < 750-800 gm ranges from 10% to 40%. • 80-95% of infants weighing < 1,500 gm are free of major sequelae. • 70-80% of infants weighing < 1,000 gm are free of major sequelae. • Less than 50% of infants weighing < 600 gm or 23-24 weeks gestation are free of major sequelae.

7. Cost of Neonatal Intensive CareNICU Charges for Prematures In USA • Mean charges per survivor for infants weighing < 500 gm US $ 250,654. • Mean charges per survivor for infants weighing 1,000 -1,500 gm $ 74,101. • Nonsurvivors median charges $ 10,706 with a median stay of 2 days; $5,353 per day.

8. Cost of Neonatal Intensive CareNICU Charges for Prematures In USA

9. Cost Of Intensive Care For Prematures In Jordan HospitalAverage Charges (JD) For All Patients By Category

10. Cost Of Intensive Care For Prematures In Jordan Hospital Comparison for Survived and Expired PatientsAverageStay ( Days ) , Cost (JD) and Birth Weight (Gm)

11. Cost Of Intensive Care For Prematures In Jordan HospitalPercentage of Hospital Charges and Professional Fees

12. Cost Of Intensive Care For Prematures In Jordan HospitalAverage Hospital Stay ( Days ) and Daily Cost (JD) by Birth Weight Groups (Gm) - All Patients

13. Cost Of Intensive Care For Prematures In Jordan HospitalAverage Charges For 500-1000 Gm PatientsBy Survival

14. Cost Of Intensive Care For Prematures In Jordan HospitalAverage Charges For 1000-1500 Gm PatientsBy Survival

15. Cost Of Intensive Care For Prematures In Jordan HospitalAverage Charges For > 3500 Gm PatientsBy Survival

16. Cost Of Intensive Care For Prematures In Jordan HospitalAverage Charges For 1500-3500 Gm PatientsBy Survival

17. Cost of Neonatal Intensive Care At Jordan HospitalSummary of Cost • Mean charges for infants with birth weight 500-1000 gm who survived was 7632 JD, nonsurvivor mean charges was 5736 JD. • Mean charges for infants with birth weight 500-1000 gm who survived was 7632 JD, nonsurvivor mean charges was 5736 JD. • Three infants not resuscitated initially, but were managed later on parents request, all died, mean charges 11617 JD.

18. Cost of Neonatal Intensive Care At Jordan HospitalSummary of Cost

19. Cost of Neonatal Intensive CareSummary of Survival-Cost • Survival rate for all infants with birth weight 1000-1500 gm was 86%. Outborn survival was 50% compared to 92% for inborn infants. Survivors mean charges 4272 JD, nonsurvivor mean charges 6048 JD. Average per day 166 JD. • Survival rates for infants with birth weight 1500-2000 & 2000-2500 gm were 100%. Mean charges was 2443 JD, and 998 JD respectively. Average per day 129 JD, and 86 JD respectively.

20. Cost of Neonatal Intensive CareSummary of Survival-Cost • Survivors mean total charges 1649 JD, nonsurvivor mean total charges 5835 JD. • Average charges for all patients was 139 JD per day, and average total charges was 1046 JD. • Average hospital stay for all patients was 5.7 days.

21. Cost of Neonatal Intensive CareRequirement for Neonatal Intensive/ Intermediate Care for Jordan • 150,000 newborns are delivered in Jordan. • About 15,000 infants will require intensive/ intermediate care. • Estimated national cost for NICU care for all infants is about 15,000 X 1,046 = 15,690,000 JD. • Estimated hospital days needed for NICU care for all infants is about 15,000 X 5.7 = 85500 hospital days. Approximately 240-250 beds NICU and Intermediate Care are needed.

22. Cost of Neonatal Intensive CareAffordable Price for Jordan 15,690,000 JD per year OR 85500 hospital days 240-250 NICU and Intermediate Care beds A cheap and affordable price for giving optimal care for our future generations. Any community can determine its own death rate.