Economic burden of hospitalizations for preterm labor in the United States

Objective: To determine patient factors associated with hospital care costs for preterm labor and to develop a clinically applicable cost model for ev aluating economic consequences of interventions to reduce preterm-labor hos pitalizations. Methods: Maryland state hospital discharge data from 1993-1996 were used to identify hospitalizations for preterm labor without delivery and preterm l abor with early delivery. Median regression was used to determine the assoc iation between patient factors and hospital care costs in Maryland and to d evelop a model to estimate hospital care costs nationally. National estimat es of hospitalizations for preterm labor were from the 1994 National Hospit al Discharge Survey. Results: During the 4-year study period, there were 25,104 hospitalizations for preterm labor, undelivered, and preterm labor with early delivery in M aryland. Maternal comorbidity, antenatal procedures, types of insurance, an d lengths of stay associated significantly with hospital costs for preterm labor. National costs for preterm labor, undelivered, were more than $360 m illion. incremental costs for preterm labor with early delivery, compared w ith term delivery, ranged from $21 million to $191 million. Total expenditu res for preterm-labor hospitalization for the United States were estimated in excess of $820 million. Conclusion: Hospitalizations for preterm labor comprise a substantial porti on of maternal cost of perinatal care in the United States. Maternal comorb idity and procedures account for major differences in costs per admission. Strategies to reduce hospitalizations for preterm labor should focus on eco nomic and clinical outcomes in evaluating their overall values. (Obstet Gyn ecol 2000;96:95-101. (C) 2000 by The American College of Obstetricians and Gynecologists.).