Economic considerations at the threshold of viability.

Autor: Yieh L; Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA 90027, USA; Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA. Electronic address: lyieh@chla.usc.edu., King BC; Department of Pediatrics, University of Pittsburgh, Pittsburgh PA, USA., Hay S; Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA; Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA., Dukhovny D; Division of Neonatology, Department of Pediatrics, Oregon Health & Sciences University, Portland, OR, USA., Zupancic JAF; Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA; Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Seminars in perinatology [Semin Perinatol] 2022 Mar; Vol. 46 (2), pp. 151547. Date of Electronic Publication: 2021 Nov 10.
DOI: 10.1016/j.semperi.2021.151547
Abstrakt: Neonatal intensive care for infants born at 22-24 weeks has become more prevalent in the past three decades, but outcomes remain highly variable between centers, in part due to different approaches in management. With this increased frequency of intervention, there has been concern for a concurrent increase in costs of care for survivors. This article reviews the direct medical, direct non-medical, and indirect costs of care for periviable infants and their families, as well as the current limitations of published data. In addition, we highlight the cost-effectiveness of neonatal intensive care and various therapies offered to extremely preterm infants, while also considering the ethical dilemmas inherently tied to periviable decision-making. Strategies to improve the gaps in knowledge on the economic impact of the smallest infants are discussed.
Competing Interests: Disclosures The authors have no relevant conflicts of interest to disclose.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: