Infant Delivery Costs Related to Maternal Smoking: Un Update

Adams, Kathleen

Thursday, August 16, 2012

Exhibit Hall (Kansas City Convention Center)

Dr. Kathleen Adams, PhD , Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, Atlanta, GA

Dr. Cathy Melvin, PhD, MPH , Maternal and Child Health , University of North Carolina Chapel Hill, Carrboro, NC

Ms. Cheryl Raskind-Hood, MS, MPH , Rollins School of Public Health, Emory University, Atlanta, GA

Mr. Peter Joski, MSPH , Kaiser Permanente of Georgia, Atlanta, GA

Ms. Ecaterina Galactionova, MA , Rollins School of Public Health, Emory University, Atlanta, GA, Atlanta, GA

Learning Objectives

At the conclusion of this presentation attendees will be able to:

Understand the public health impact of maternal smoking infant delivery costs.

Cross Cutting Program Area(s): Cessation and Evaluation and Surveillance

Audience: Policy makers, health services administrators, and program developers in settings serving pregnant women and/or offering preganancy and delivery services.

Key Points: Adverse maternal and infant health outcomes due to maternal smoking (MS) are known. Changes in antenatal and neonatal care, medical care inflation, and declines in MS prevalence prompted us to update 1996 estimates of health care costs for infants at delivery attributable to MS. We used Pregnancy Risk Assessment Monitoring System 2001/2002 data to estimate the association of MS to Neonatal Intensive Care Unit (NICU) admission and, in turn, length of stay for infants admitted/not admitted. Models used 2003 natality files to derive predicted expenses “as is” and “as if” mothers did not smoke. Updated analysis incorporated Hispanic ethnicity, data from 27 instead of 13 states, and updated (2004) NICU nightly costs. The difference in predicted expenses is smoking attributable expenses (SAEs). Compared to earlier work, we find no significant association of MS and NICU admission but rather, a positive effect on length of stay of exposed infants once admitted to the NICU. SAEs estimates were $122 million (CI = -$29m to $285m) nationally and $279 (CI = -$76 to $653) per maternal smoker in 2004 dollars. Declines in MS prevalence (mid-1990s and 2003) between the mid-1990s and 003 combined with a weaker relationship of MS to NICU admission offset medical care inflation such that infants’ SAEs declined. application of findings.

Educational Experience: Lecture with guided discussion.

Benefits: Increased understanding of how maternal smoking affects infant delivery costs

366 Infant Delivery Costs Related to Maternal Smoking: Un Update