Published on January 9, 2010
The Margins of Viability Stephen Kinsella** Dominic Trepel** Fiona McElligott * Roy K Philip* *Regional Maternity Hospital **University of Limerick
What we did. Question: How much did it cost to keep 1 ELBW infant alive for 212 days in hospital? Answer: 611,000 euros. Method: calculation of total costs from highly detailed data set gathered from patient, painstaking attention to details of the case. Marginal costs calculated as TC = €611,497,38, 1 week of extra life cost €8531.00, Fixed cost: €28,755.00. Conclusion: very precise data implies much larger cost than other US/UK studies have found.
Background Our study examines the cost of care in the case of an extremely low birth weight (ELBW) infant. Birth at 24 weeks: the marginal case Many procedures required to keep patient alive 212 days in hospital Q: How much did this cost?
176 variables Data 17 different antimicrobials, 479 ‘antibiotic days’ 369 ‘diuretic-days’ 95 ventilation days 86 transfusions 83 radiological procedures including 47 X-rays, 1 MRI, 35 ultrasound scans (head, abdomen, heart) 940 laboratory investigations 2 x National Neonatal Transport Transfer Family’s Time, Equipment Maintenance, Refurbishment, and more...
Method Assigned unit costs to chart variables. Calculated Fixed, Variable, Total and Marginal Costs daily as TC: Total T Ct Cost = M Ct Qt−1 Q: Extra day of life
Day 19 Fungal Sepsis, Day 202 Transfer to Crumlin RSV Vaccination
Total Cost TC = €611,497,38 1 week: cost €8531.00 Fixed cost: €28,755.00
Cost reduction as we approach discharge
Conclusions Very precise data implies increased cost TC, MC substantially larger than UK, US estimates. Possible benchmark case for a larger study of neonates in midwest region
Problems/Next Steps 1. Clearly, econometrics inappropriate, MLE/ Spline estimation to follow 2. Problem of generalisation from 1 case 3. Clear break from levels reported
The lecture notes were preserved by Aristotle's former students (including his son Nichomachus, from whom the title derives its name) after his death, and ...
The Margins of Viability 3 will be used to create a pilot model for cost comparison, following the local delivery of a 24/40-week gestation infant.
Abstract Background: Prematurity and extremely low birth-weight (ELBW) is a well recognised financial burden on health care in the developed world. Cost of
The resuscitation of the very preterm infant at the margins of viability is an issue fraught with controversy. The position statement from the Canadian ...
ETHICAL DILEMMAS 86 VOLUME 4 ISSUE 3 2008infant hours, days or weeks before delivery6. Joint counselling by an experienced obstetrician and neonatologist ...
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The ethics of neonatal resuscitation at the margins of viability: informed consent and outcomes. Janvier A(1), Barrington KJ.
The Ethics of Neonatal Resuscitation at the Margins of Viability: Informed Consent and Outcomes
The Margins of Viability. by stephen-kinsella. on Feb 01, 2015. Report Category: Business
Ethics at the Margins of Viability on ResearchGate, the professional network for scientists.