Cost-of-illness analysis of preterm births in France

Abstract

Objectives: To evaluate the average direct medical costs of very preterm births (≤ 32 wGA) during the first year of life, within the framework of the French health insurance system. Comparison with other preterm (33-37 wGA) and term births (≥ 37 wGA). Methods: Extraction from the French national health insurance information system (SNIIRAM) of all hospital stays and non-hospital care, and the amounts paid by the public insurance system, detailed for each birth in the 2009-2010 period. Mann Whitney tests were used for descriptive and comparative analyses. Results: Extraction of 467,106 single births, among which 0.71% were very preterm (and 4.96% were preterm (< 37 wGA)). For very preterm births (and all preterm), the hospital stays accounted for 14% (and 26%) of the total hospital costs in the total population. The average hospital costs in the whole first year of life were 25 (and 7) times higher than those for term births. The non-hospital care accounted for 3% (and 10%) of the total non-hospital costs in the total population. The average non-hospital costs were 5 (and 2) times higher than those for term births. Conclusion: Our work presents the first economic study of prematurity in France. It could be used to justify the implementation of the improved strategies to prevent prematurity and its consequences.