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Journal of the Korean Society of Neonatology 2010;17(1):13-20.
Published online May 1, 2010.
Rehospitalization Rate and Medical Cost of Infants in the First Year after Discharge from Neonatal Intensive Care Units.
Chong Woo Bae, Kye Shik Shim, Won Ho Hahn, Ki Soo Kim, Beyong Il Kim, Son Moon Shin, Sang Lak Lee, Baek Keun Lim, Young Youn Choi
1Department of Pediatrics, Kyung Hee University East-West Neo Medical Center, Seoul, Korea. baecw@khnmc.or.kr
2Department of Pediatrics, KyungHee University Medical Center, Seoul, Korea.
3Department of Pediatrics, Ulsan University Asan Medical Center, Seoul, Korea.
4Department of Pediatrics, Seoul National University Bundang Hospital, Sungnam, Korea.
5Department of Pediatrics, Kwandong University Cheil General Hospital, Seoul, Korea.
6Department of Pediatrics, Keimyung University Dongsan Medical Center, Daegu, Korea.
7Department of Pediatrics, Yonsei University Wonju College of Medicine Wonju Christian Hospital, Wonju, Korea.
8Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea.
신생아중환자실 입원자의 퇴원 후 재입원의 빈도와 의료비용
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Abstract
PURPOSE
Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations.
METHODS
The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed.
RESULTS
The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively.
CONCLUSION
The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.
Key Words: Newborn; Neonatal intensive unit; Admission; Discharge; Cost


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