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The financial burden experienced by families of preterm infants after NICU discharge

Journal of Perinatology volume 42, pages 223–230 (2022)Cite this article

Subjects

Abstract

Background and objectives

Describe the financial burden and worry that families of preterm infants experience after discharge from the neonatal intensive care unit (NICU).

Methods

We surveyed 365 parents of preterm infants in a cross-sectional study regarding socio-demographics, supplemental security income (SSI), and financial worry. We completed a multivariable logistic regression model to examine the adjusted association of financial worry with modifiable factors.

Results

We found that 53% of participants worried about healthcare costs after NICU discharge. After adjusting for socio-demographic and infant characteristics, we identified that, aOR (95% CI), out-of-pocket costs from the NICU index hospitalization, 3.51 (1.7, 7.26) and durable medical equipment use, 2.41 (1.11, 5.23) was associated with increased financial worry while enrollment in SSI, 0.38 (0.19, 0.76) was associated with decreased financial worry.

Conclusions

We identified factors that could contribute to financial burden after NICU discharge that may advise future work to target financial support systems.

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Fig. 1
Fig. 2: Costs related to travel to appointments and for childcare for other siblings.

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Acknowledgements

We would like to acknowledge: the support of the Teresa and Byron Pollitt Family Chair in Fetal and Neonatal Medicine, Sylvia Magallon, RN for her assistance as the manager of the High Risk Infant Follow Up Program at the Fetal and Neonatal Institute and Brooke Corder at Boston Children’s Hospital for their assistance with recruitment, Ms. Griselda Monroy, Ms. Rachel Polcyn, and Ms. Bernadette Lam for their assistance with data collection. We would like to thank Drs. Tracy Lieu, Alison Gailbraith, and Dr. Karen Kulthau for their contribution to study design and survey development. Finally, we would like to thank the families who participated in this study.

Funding

This study was supported by the Richardson Fund with the Department of Neonatology, Beth Israel Deaconess Medical Center, Boston MA, the Program for Patient Safety and Quality (PPSQ) at Boston Children’s Hospital, Boston, MA, the Medical Staff Organization at Boston Children’s Hospital, Boston, MA, the Confidence Foundation, the Saban Research Award and the Lucile Packard Young Investigator Award for Children with Special Health Care Needs. AL is supported by grants from the Sharon D. Lund Foundation and the Zumberge Diversity and Inclusion Award. The funder/sponsor did not participate in the work.

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Authors and Affiliations

  1. Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Ashwini Lakshmanan, Leah Yieh, Philippe S. Friedlich & Cynthia L. Gong

  2. Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA

    Ashwini Lakshmanan, Leah Yieh & Cynthia L. Gong

  3. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Ashwini Lakshmanan

  4. Department of Preventive Medicine, Johns Hopkins University, Baltimore, MD, USA

    Ashley Y. Song

  5. Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Mandy B. Belfort

  6. Division of Neonatology, Department of Pediatrics, Oregon Health Sciences University, Portland, OR, USA

    Dmitry Dukhovny

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  1. Ashwini Lakshmanan
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  7. Cynthia L. Gong
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Contributions

The corresponding author confirms that she has had full access to the data in the study. All authors hold final responsibility for the decision to submit for publication. The following are the contributions of each author: AL, AYS, MBB, LY, DD, PSF, and CLG—conceived and/or designed the work that led to the submission, and/or acquired data, and/or played an important role in interpreting the results. AL—drafted the manuscript. AL, AYS, MBB, LY, DD, and PSF—revised the manuscript; All authors—approved the final version and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Ashwini Lakshmanan.

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The authors declare no competing interests.

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The Boston Children’s Hospital and Children’s Hospital Los Angeles human subjects committees approved the study protocol.

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Lakshmanan, A., Song, A.Y., Belfort, M.B. et al. The financial burden experienced by families of preterm infants after NICU discharge. J Perinatol 42, 223–230 (2022). https://doi.org/10.1038/s41372-021-01213-4

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