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Hospital Financial Assessment

Hospital Financial Assessment. Annual Cost of NEC. Mortality Rates for NEC Range from 20-40% of All cases. Reference: Pediatrics 2002;109,423-428;Impact of Necrotizing Enterocolitis on Length of Stay and Hospital Charges in Very Low Birth Weight Infants

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Hospital Financial Assessment

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  1. Hospital Financial Assessment

  2. Annual Cost of NEC Mortality Rates for NEC Range from 20-40% of All cases • Reference: Pediatrics 2002;109,423-428;Impact of Necrotizing Enterocolitis on Length of Stay and Hospital Charges in Very Low Birth Weight Infants • Chart based on taking 40% of the NEC population requiring surgery and 60% having Medical NEC • VON reports that 12% of patient population under 27 weeks develop NEC and 2% over the entire NICU population

  3. 6,000,000 50% BF Rate Baseline 60% BF Scenario 70% BF Scenario 80% BF Scenario 90% BF Scenario 100% BF Scenario 5,000,000 4,000,000 3,000,000 Hospital Incurred Cost ($$) 2,000,000 1,000,000 0 Baseline 1%NEC Baseline 3%NEC Baseline 5%NEC Baseline 7%NEC Baseline 10%NEC Increased Breastmilk Usage Translating into Savings • Exclusively formula fed babies are 6-7 more times likely to develop NEC than exclusively breastmilk fed babies and 3 times more likely than those receiving both. (Graph assumes a 7x increase) • Chart Based on VON data of ~50% as a baseline of Population receiving some breastmilk by discharge • Baseline NEC rates are on the bottom and are represented with the 50% BF rate. By increasing the BF rates, the NEC percentages decrease • Based Hospital Admission of 500 annually

  4. NEC • Medical NEC • exhibits signs/symptoms without perforation • Adds 22 additional days to LOS • Increases death by 14% • Overall hospital charges $300,000 $73K in incremental hospital charges • Surgical NEC • radiographic evidence of perforated bowel • Adds 60 additional days to LOS • Increases death by 24.5% • Overall hospital charges $450,000 $190K in incremental hospital charges

  5. Additional Benefits of Breastmilk in the NICU • For every 10-ml/kg per day increase in • Breastmilk ingestion: • The Mental Development Index Increased • by 0.53 points • The Psychomotor Development Index • increased by 0.63 points • Behavior Rating Scale Percentile Score • increased by 0.82 points • Likelihood of rehospitalization decreased • by 6% Vohr et al., Beneficial effects of breastmilk in the neonatal intensive care unit on the developmental outcome of extremely low birthweight infants at 18 months of age; Pediatrics 2006;118;e115-e123 Schanler et al., Pediatrics 103, 1999;1150-1157

  6. Impact of a Strong Lactation Program for Neonates2 Year Study Performed at Children’s Hospital of the King’s Daughters in Norfolk, VA • Usual Support encompassed • period between 1996-1998 • when no lactation support • was available • IBCLC Support encompassed • 2 full time IBCLC’s with RN • backgrounds and a 3rd in • training Gonzalez et al.,Journal of Human Lactation 2003:19:286

  7. Cost Benefit of a NICU Lactation Program Lactation FTE’s – Assume $100,000 (Salary + Benefits) Assume RN with IBCLC Assume 2 FTE = $200,000 Pumps No Charge Kits Based on 500 Annual Admissions 80% Breastfeeding Rate Total Kits Consumed 400 + 20% contingency for replacements Total Kits Consumed 480 $13,000 Annually Containers Assume Annual Usage of 140,000 units Annual Cost = $35,000 Total Cost: $257,000 annually

  8. References

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