COST OF CARE FOR A GEOGRAPHICALLY DETERMINED POPULATION OF LOW-BIRTH-WEIGHT INFANTS TO AGE 8-9 YEARS .1. CHILDREN WITHOUT DISABILITY

Aim-To determine the extra cost of healthcare associated with low birt hweight, in a cohort study of a geographically defined population in f ive health districts that comprise Merseyside. Methods-The study compr ised all children of birthweight less than or equal to 1500 g and a 10 % random sample of those weighing 1501-2000 g, without clinical disabi lity, born in 1980 and 1981 to mothers resident in Merseyside, and the ir controls, matched by age, sex, and school class, followed up to age 8-9 years. Results-The cost of care associated with the initial admis sion to the neonatal special/intensive care unit and subsequent use of hospital and family practitioner services was assessed. There were 64 1 survivors without disability and 227 nonsurvivors who weighed less t han or equal to 2000 g at birth. The mean cost of neonatal care per lo w birthweight child was 13 times greater than for a control child. For children weighing less than or equal to 1000 g at birth, neonatal cos ts were 55 times greater than for the control children. Low birthweigh t children continue to use hospital and family practitioner services m ore intensively than controls to age 8-9 years. Conclusion-Low birthwe ight children used hospital and family practitioner services more inte nsively throughout the follow up period. Whether the increased use of health services persists into adolescence and adulthood is yet to be d etermined.