COST OF CARE FOR A GEOGRAPHICALLY DETERMINED POPULATION OF LOW-BIRTH-WEIGHT INFANTS TO AGE 8-9 YEARS .2. CHILDREN WITH DISABILITY

Aim-To determine the cost of health and educational service provision for low birthweight children with a clinical disability. Methods-Cohor t study of a geographically defined population in five health district s that comprise the County of Merseyside was undertaken. All children with a clinical disability born in 1980 and 1981 to mothers resident i n the County of Merseyside were followed up to age 8-9 years. The cost of care associated with the initial admission to the neonatal special / intensive care unit and subsequent use of hospital, family practitio ner, and special education services was assessed. Results-There were 5 2 children with a disability; the disability rate in children of birth weight less than or equal to 2000 g was estimated at 7.7%. Of the tota l expenditure to age 8-9 years, special education was the largest cate gory (52%) and neonatal care accounted for 35%. The disabled children accounted for 38% of the cost of the whole cohort of 693 disabled and non-disabled children who weighed less than or equal to 2000 g at birt h. Conclusion-In a cohort of low birthweight children, those who are d isabled account for a disproportionate amount of the total expenditure to age 8-9. The cost of long term care for disabled young persons and adults will increasingly dominate the cost of care for the whole coho rt of low birthweight children.