This retrospective study compares the cost and quality outcomes of two
matched groups of infants; one of which received neonatal care provid
ed by neonatal nurse practitioners (NNPs), the other delivered by the
medical house staff in one hospital's NICU. Parameters evaluated for b
oth groups included LOS, days on ventilator, days on oxygen, mortality
, morbidity, and costs. The infants in the study were matched by place
of birth, gestational age, birth weight, sex, race, and Apgar scores.
This study showed that in the 35 cases cared for by NNPs, in collabor
ation with neonatoologists, neonates received care equal in quality to
the 35 matched cases cared for by medical house staff at lower cost w
ith greater continuity and consistency. Cost effectiveness of the NNP
group was documented as $18,240 less per infant than those managed by
medical house staff. Differences were seen as chiefly attributable to
the NNP's unique blend of knowledge, communication skills, and continu
ous presence plus early identification of service coordination needs.