It is often said that a premature is expensive and that there are many costs involved. But how much does a premature cost? And how much does a premature cost in the long term?
How much is a premature during hospitalization?
First we start with the annual healthcare costs in the Netherlands. Research has been carried out on early birth care expenditure in 2019. This expenditure amounted to EUR 132.1 million. This represents about 0.14% of total healthcare expenditure for Dutch healthcare. Most of the expenditure, EUR 125 million or 94%, goes to hospital care.
Most of it goes to newborns in the first year of life. This consists of 92%, the remaining 8% goes to children and teenagers. There are also differences in care expenses between boys and girls. In boys, spending is 55% and in girls 45%.1
The average costs in the Netherlands of extreme premature birth have increased over the years. This is what researchers found when looking at the level of hospital costs of premature births between 1999 and 2015.
The average cost of hospitalisation was:
- For the whole group of premature births: €126.350
Average cost per period:
- 1999 to 2005: €110.600
- 2006 to 2009: €119.350
- 2010 to 2015: €138.800
And if the average cost of babies with and without BPD (Bronchopulmonal Dysplasia) or CLD (chronic lung disease) are compared:
- Babies without BPD or CLD: €85.050
- Babys with BPD or CLD: €188,650
The average cost of care for premature births increased between 1999 and 2015. This may have to do with a higher survival rate and because babies can be born earlier. Hospitalisation and total cost up to the corrected 1st and 2nd year of life were higher for children with broncho-pulmonary dysplasia and CLD than for children without any of these conditions.2
How much is a premature at the age of five?
In a European study, the costs were examined in the 5th year of life. Data were collected from Belgium, Denmark, Germany Estonia France, Italy, the Netherlands, Portugal, Poland, the United Kingdom and Sweden.
From a social point of view, average costs in Poland are high. €4.380 and the lowest in the Netherlands with hindered 508. The main share of costs associated with early birth during the 5th year of life are indirect costs (e.g. due to absenteeism of parents). For the vast majority of countries these indirect costs are more than half of the average costs of early birth. In all countries, the study showed that there are more costs associated with a shorter gestation period <28 weeks, except in Belgium, Estonia and Germany. In Denmark, France, Italy, the Netherlands, Poland, Portugal, the United Kingdom and Sweden higher costs have been demonstrated in an extreme premature birth.
When considering the social costs per pregnancy compared to a duration of 30-31 weeks, the researchers find that:
- <26 weeks €2.756
- 26-27 weeks €752
- 28-29 weeks takes an early birth €657
When other factors are included in the costs such as birth defects, post-birth health problems, male gender and low-educated mothers, there is something different per point:
- Congenital disorder costs €3.113
- Health problems after birth cost €3.234
- Male sex cost €1.227
- Low-skilled mothers €625
As soon as certain diagnoses are omitted, such as bronchopulmonary dysplasia, one or more health problems after birth and congenital abnormalities, additional costs are reduced:
- <26 weeks €341 less
- 26-27 weeks €87 less
- 28-29 weeks €31 less
From this research came among other things that the costs of early birth increase as a child is born earlier. Children born at <26 weeks, 26-27 or 28-29 weeks cause higher social costs than children born at 30-31 weeks. These costs were therefore even higher in the fifth year of life. Furthermore, there were also higher costs for boys which follow the line in research where boys have a higher risk of neurological and motor problems.3
How much is a premature at the age of 18?
There are no Dutch figures on the long term costs above the fifth year of life. However, there are figures from England and Wales that have studied children under 18 years of age. They have examined the additional costs in pounds of English per child born prematurely. They have included the degree of prematureity. These costs shall be borne by the seriously premature births. £103,831 and for those seriously premature £136,790. When compared to those born on time, the additional costs per prematurely born child are up to the 18th year of life £22,764.4
In summary, an early birth is more expensive than a birth that takes place on time. It still pertains to the country in which the child was born and to other factors such as certain diseases. An early birth is expensive in itself and these costs remain present during the life of a premature.
Bibliography:
1. de Weerdt, A.C., Gouwens, S., Koopmanschap, M.A., van der Meer, A., Kommer, G.J. (2022, June) Early birth, underweight and/or growth delay, Healthcare expenditure. Fetched from RIVM: https://www.vzinfo.nl/early birth-underweight-and-growth retardation/care expenditure
2. Houben E, Siffel C, Overbeek J, Penning-van Best F, Niklas V, Sarda SP. (2021 Jan-dec; 24(1):1290-1298). Respiratory morbidity, healthcare resource use, and cost burden associated with extremely premature birth in The Netherlands. Taylor and Francis group: https://www.tandfonline.com/doi/epdf/10.1080/136998.2021.1999664?needAccess=true
3. Kim, S.W., Andronis, L., Seppänen, AV. et al. (2022). Economic costs at age five associated with very preterm birth: multinational European cohort study. Picked up from Pediatr. Res. 92, 700–711: OJ L 347, 20.12.2013, p. 671.
4. Lindsay J. Mangham, Stavros Petrou, Lex W. Doyle, Elizabeth S. Draper, Neil Marlow. (2009, February). The Cost of Preterm Birth Throughout Childhood in England and Wales. Pediatrics picked up: https://publications.aap.org/pediatrics/article-abstract/123/2/e312/69430/The-Cost-of-Preterm-Birth-Throughout-Childhood-in
