Resource utilization patterns using non-invasive ventilation in neonates with respiratory distress syndrome

J Perinatol. 2018 Jul;38(7):850-856. doi: 10.1038/s41372-018-0122-y. Epub 2018 May 24.

Abstract

Objectives: To describe the frequency of non-invasive ventilation (NIV) and endotracheal intubation use in neonates diagnosed with respiratory distress syndrome (RDS); to describe resources utilization (length of stay (LOS), charges, costs) among NIV and intubated RDS groups.

Study design: Retrospective study from the national Kid's Inpatient Database of the Healthcare Cost and Utilization Project, for the years 1997-2012. Propensity scoring and multivariate regression analysis used to describe differences.

Results: A total of 595,254 out of 42,912,090 cases were identified with RDS. There was an increase in NIV use from 6% in 1997 to 17% in 2012. After matching, patients receiving NIV only were associated with shorter LOS: (95%CI) 25 (25.3,25.7) vs. 35 (34.2,34.9) days, decreased costs: ($/1k) 46.1 (45.5,46.8) vs. 65.0 (64.1,66.0), decreased charges: 130.3 (128.6,132.1) vs. 192.1 (189.5,194.6) compared to intubated neonates.

Conclusion: There was a three-fold increase in NIV use within the 15-year study period. NIV use was associated with decreased LOS, charges and costs compared to intubated patients.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Cohort Studies
  • Cost Savings
  • Databases, Factual
  • Female
  • Health Resources / economics
  • Hospital Costs*
  • Hospitals, Pediatric
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Intensive Care Units, Neonatal / economics
  • Intubation, Intratracheal / economics*
  • Intubation, Intratracheal / methods
  • Length of Stay / economics
  • Linear Models
  • Los Angeles
  • Male
  • Multivariate Analysis
  • Noninvasive Ventilation / economics*
  • Noninvasive Ventilation / methods*
  • Noninvasive Ventilation / mortality
  • Propensity Score
  • Respiratory Distress Syndrome, Newborn / economics
  • Respiratory Distress Syndrome, Newborn / mortality
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Retrospective Studies