Hospital Financial Assessment

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Hospital Financial Assessment
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Annual Cost of NEC
Mortality Rates for NEC Range from 20-40 of All
cases

• Reference Pediatrics 2002109,423-428Impact of
  Necrotizing Enterocolitis on Length of Stay and
  Hospital Charges in Very Low Birth Weight Infants
• Chart based on taking 40 of the NEC population
  requiring surgery and 60 having Medical NEC
• VON reports that 12 of patient population under
  27 weeks develop NEC and 2 over the entire NICU
  population

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Increased Breastmilk Usage Translating into
Savings

• Exclusively formula fed babies are 6-7 more times
  likely to develop NEC than exclusively breastmilk
  fed babies and 3 times more likely than those
  receiving both. (Graph assumes a 7x increase)
• Chart Based on VON data of 50 as a baseline of
  Population receiving some breastmilk by discharge
• Baseline NEC rates are on the bottom and are
  represented with the 50 BF rate. By increasing
  the BF rates, the NEC percentages decrease
• Based Hospital Admission of 500 annually

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NEC

• Medical NEC
• exhibits signs/symptoms without perforation
• Adds 22 additional days to LOS
• Increases death by 14
• Overall hospital charges 300,000
• 73K in incremental hospital charges
• Surgical NEC
• radiographic evidence of perforated bowel
• Adds 60 additional days to LOS
• Increases death by 24.5
• Overall hospital charges 450,000
• 190K in incremental hospital charges

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Additional Benefits of Breastmilk in the NICU
Outcome Fortified HM Preterm Formula
O2 Therapy (days) 1921 3341
NEC (n) 1(1.6) 6(13)
Surgical NEC (n) 0 3
Late-Onset Sepsis n, () 19(31) 22(48)
Late-Onset Sepsis of episodes/patient 0.30.5 0.60.7
Positive Blood Cultures (/infant) 0.50.9 1.21.7
NEC or Sepsis, n () 19(31) 25(54)
GERD Medications () 16 39

• For every 10-ml/kg per day increase in
• Breastmilk ingestion
• The Mental Development Index Increased
• by 0.53 points
• The Psychomotor Development Index
• increased by 0.63 points
• Behavior Rating Scale Percentile Score
• increased by 0.82 points
• Likelihood of rehospitalization decreased
• by 6

Schanler et al., Pediatrics 103, 19991150-1157
Vohr et al., Beneficial effects of breastmilk in
the neonatal intensive care unit on the
developmental outcome of extremely low
birthweight infants at 18 months of
age Pediatrics 2006118e115-e123
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Impact of a Strong Lactation Program for
Neonates2 Year Study Performed at Childrens
Hospital of the Kings Daughters in Norfolk, VA

• Usual Support encompassed
• period between 1996-1998
• when no lactation support
• was available
• IBCLC Support encompassed
• 2 full time IBCLCs with RN
• backgrounds and a 3rd in
• training

Gonzalez et al.,Journal of Human Lactation
200319286
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Cost Benefit of a NICU Lactation Program
Lactation FTEs Assume 100,000 (Salary
Benefits) Assume RN with IBCLC Assume 2 FTE
200,000 Pumps No Charge Kits Based on 500
Annual Admissions 80 Breastfeeding
Rate Total Kits Consumed 400 20 contingency
for replacements Total Kits Consumed
480 13,000 Annually Containers Assume Annual
Usage of 140,000 units Annual Cost
35,000 Total Cost 257,000 annually
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References