TY - JOUR
T1 - Economic considerations at the threshold of viability
AU - Yieh, Leah
AU - King, Brian C.
AU - Hay, Susanne
AU - Dukhovny, Dmitry
AU - Zupancic, John A.F.
N1 - Funding Information:
Dr. Yieh's work is supported by K12 Pediatrician-Scientist Research Career Development Award (00011187), Department of Pediatrics, Children's Hospital Los Angeles.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/3
Y1 - 2022/3
N2 - Neonatal intensive care for infants born at 22–24 weeks has become more prevalent in the past three decades, but outcomes remain highly variable between centers, in part due to different approaches in management. With this increased frequency of intervention, there has been concern for a concurrent increase in costs of care for survivors. This article reviews the direct medical, direct non-medical, and indirect costs of care for periviable infants and their families, as well as the current limitations of published data. In addition, we highlight the cost-effectiveness of neonatal intensive care and various therapies offered to extremely preterm infants, while also considering the ethical dilemmas inherently tied to periviable decision-making. Strategies to improve the gaps in knowledge on the economic impact of the smallest infants are discussed.
AB - Neonatal intensive care for infants born at 22–24 weeks has become more prevalent in the past three decades, but outcomes remain highly variable between centers, in part due to different approaches in management. With this increased frequency of intervention, there has been concern for a concurrent increase in costs of care for survivors. This article reviews the direct medical, direct non-medical, and indirect costs of care for periviable infants and their families, as well as the current limitations of published data. In addition, we highlight the cost-effectiveness of neonatal intensive care and various therapies offered to extremely preterm infants, while also considering the ethical dilemmas inherently tied to periviable decision-making. Strategies to improve the gaps in knowledge on the economic impact of the smallest infants are discussed.
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U2 - 10.1016/j.semperi.2021.151547
DO - 10.1016/j.semperi.2021.151547
M3 - Article
C2 - 34887108
AN - SCOPUS:85120704501
SN - 0146-0005
VL - 46
JO - Seminars in Perinatology
JF - Seminars in Perinatology
IS - 2
M1 - 151547
ER -