37 COST EFFECTIVENESS OF NEONATAL INTENSIVE CARE (NIC)

The fully allocated costs of hospital care from birth to final discharge were determined and compared to survivorship in two cohorts of <1500g birth weight infants. Study infants included all 500 to 1499g babies liveborn in Hamilton-Wentworth from 1964-69 and 1973-77 (before and after the introduction of the McMaster Regional Perinatal Program). Survivors numbered 157/376 (42%) and 251/416 (60%). For the ascertainment of costs, two random samples, stratified by birth weight and outcome, were selected: 77/376 infants (20%) and 83/416 (20%) from ′64-69 and ′73-77 respectively. Cohort costs in 1978 dollars amounted to $1299490 (′64-69) and $5800896 (′73-77). After making the cohorts equal in size, the following comparisons were made:For the defined costs and effects the post NIC period is both more costly (by $4363163) and more effective (by 77.3 survivors) than the pre-NIC period, resulting in a cost of $56445 per additional survivor. In deciding whether NIC is a good health care investment, it is necessary to compare these results to comparably measured costs and effects from alternative programs offered by the health care system.