Author: Kim Carmignani, MSN, RN-NIC
In the current healthcare system, hospitals are seeking to improve their metrics by both decreasing costs for inpatient medical stay and decreasing the patient’s length of stay. This includes taking a closer look at infants born at or below 1500 grams or those considered very low birth weight (VLBW). These patients are often some of the most expensive patients in the hospital due to their increased risk for prematurity-related morbidities. Johnson and colleagues (2014) conducted a literature review to quantify the benefits of human milk feedings and costs associated with the care of VLBW infants.
A baseline hospitalization cost for a VLBW without prematurity-related morbidity in 2009 was $ 40,227. After adjusting for outlying factors, the incremental cost of select morbidities ranged from $23,901 for late-onset sepsis to $58,686 for bronchopulmonary dysplasia (BPD). Therefore, the avoidance of potentially preventable morbidities is an economic benefit for hospitals. In another paper, Petrou et al identified 19 studies that showed the relationship between infant birth weight (BW) and cost incurred in the NICU stay – “relation between infant BW and costs is due to both longer NICU stays and more intensive resource use… as well as higher incidence of costly morbidities.”
In addition to recognizing the cost of morbidities, Johnson et al summarize the impact of a human milk diet on long-term outcomes including neurodevelopmental and neurocognitive problems. Utilization of a human milk diet which has been shown to reduce the risk of morbidities impacting both short-term and long-term outcomes. Although it is recognized that there are costs to the institution in providing human milk feedings, these costs are outweighed by the benefits. The direct and indirect downstream savings that the hospital can demonstrate through decreased prematurity-related morbidities, overall costs and length of stay. (Photo credit: Johnson, et. al).
Reference: Johnson TJ, Patel AL, Bigger HR, Engstrom JL, Meier PP. Economic benefits and costs of human milk feedings: a strategy to reduce the risk of prematurity-related morbidities in very low birth weight infants. Adv Nutr 2014;5:207-212. doi: 10.3945/ an.113.004788