Direct, non-medical out-of-pocket expenditures for mothers of moderate or late preterm infants in a level II NICU: Comparison of Alberta Family Integrated Care versus standard care

Objective: To compare direct, non-medical out-of-pocket expenditures (OOPE) between mothers receiving Alberta Family Integrated Care (FICare™) versus standard care (SC) during their infant's neonatal intensive care unit (NICU) admission and explore factors influencing spending extremes.

Methods: In this exploratory, concurrent mixed-methods sub-study, we compared mother-reported OOPE from Alberta FICare™ and SC parent journals. We thematically analyzed hand-written notes from 30 journals with the highest and lowest 5 % of OOPE.

Results: There was no difference in total direct, non-medical OOPE between Alberta FICare™ (n = 194) and SC (n = 132) groups (U = 12,679.50, p = 0.882). Compared to mothers receiving SC, mothers receiving Alberta FICare™ reported spending less for parking (U = 970.00, p < 0.001) and more for food (U = 14,857.50, p = 0.014) and lodging (U = 15,160.00, p < 0.001). Spending extremes related to travel and proximity of the NICU to their home.

Conclusion: Total family financial burden was similar between groups; there were differences in spending categories. Supports to offset OOPE, particularly for families living distant to the NICU or facing transportation challenges, would reduce financial burden and could enhance family-integrated care.

Innovation: This novel analysis describes mother-reported OOPEs and strategies to mitigate financial barriers to family integrated care.