Fatores associados aos custos de internação de recém-nascidos prematuros no Brasil: um estudo retrospectivo nacional

Abstract

lntroduction: Prematurity accounts for 75% of neonatal morbidity, imposing a substantial burden on healthcare services that extends beyond the neonatal period and leading to considerable healthcare costs. This study aimed to investigate factors associated with inpatient healthcare costs for preterm born infants in the first year of life in Brazil. Methods Population-based cohort study conducted from the perspective of the Brazilian public health system. We linked infants from the National Live Birth lnformation and Hospital lnformation Systems using deterministic record linkage. lnfants born prematurely between January 2017 and December 2022, admitted to hospitais in the first year of life were included. Data on gestational age (GA), 5-minute Apgar score (Apgar5), type of delivery and inpatient healthcare costs in Reais (R$) were extracted from the data bases. Generalized linear regression was adopted to analyze the association between GA, Apgar5, type of delivery and the dependent variable, inpatient care costs. Results A total of 196,375 preterm born infants were linked. Each additional week of gestational age was associated with a reduction in inpatient healthcare costs of R$1,543.87 (95CI%: -1568.85; - 1518.89) and each additional point increase in Apgar 5 with a reduction of R$722.67 (95CI%: - 765.83; -679.51). Vaginal delivery was associated with a decrease of R$1,350.26 (95CI%: - 1429.51; -1271.01) compareci to cesarean section. Conclusions Higher gestational age, higher 5-minute Apgar score and vaginal delivery were associated with a significant reduction in inpatient care costs. Public policies aimed at reducing the rate of preterm births and promoting vaginal births in Brazil are essential for reducing hospital costs in the country.