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Intensive Care for Newborns is Good Investment

Data from Mexico likely valid for other middle-income countries

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New research suggests neonatal intensive care is cost effective in countries which are economically similar to Mexico, but maybe not in very poor countries.
New research suggests neonatal intensive care is cost effective in countries which are economically similar to Mexico, but maybe not in very poor countries.

Premature and low birth weight babies are surviving as never before, thanks to treatments available in neonatal intensive care units. That's mainly true in rich countries. But a new study suggests that these high-tech, high-intensity hospital services make economic sense in middle-income countries, too.

The often amazing results from neonatal intensive care comes at a hefty price in rich countries — doctor and hospital bills often climb into the tens of thousands of dollars, or more.

Medical care is cheaper in countries like Mexico, but people have less money, and there are many other competing medical needs.

So Joshua Salomon of the Harvard School of Public Health and his colleagues analyzed the costs and results of neonatal intensive care in Mexico. Using government data, they factored in the costs of medical care plus the costs of taking care of babies who survived with mental or physical disabilities against the value of longer life for babies who might not otherwise have survived.

Salomon says they concluded neonatal intensive care is a very good investment.

"Neonatal intensive care actually provides exceptionally high value for money when you tally up all of the short-term and long-term health gains against the relatively high cost of the intervention itself," he said in a telephone interview.

For example, infants born about 25 weeks after conception — about 15 weeks premature — typically lived 28 years longer by being placed in intensive care, at a cost of $1,200 for each year of healthy life gained.

Salomon says his research validates the cost-effectiveness of neonatal intensive care in countries economically similar to Mexico, but maybe not to very poor countries, where there may be more pressing needs for scarce medical resources.

"I think that our results, while they're based on data from Mexico, will generalize to an array of other middle-income countries. I would be more circumspect in trying to extrapolate to very low resource countries."

Harvard professor Joshua Salomon's research paper is published in the journal PloS Medicine, where he is a member of the editorial board.

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