550 EFFICACY AND COST OF INTERMEDIATE LEVEL NEWBORN INTENSIVE CARE (INIC) IN A LOW BIRTH WEIGHT (LBW) POPULATION IN CALCUTTA, INDIA

Abstract

Although intensive care has resulted in an improved prognosis for LBW infants, these benefits have only been realized in prosperous nations. The efficacy and cost of implementing a program of INIC (Level II) was retrospectively evaluated over a four year period in Calcutta, India. The patient population (94.7% ≤2500 g) included all infants admitted to the facilities operated by the International Mission of Hope (India) Society. Survival was compared within 250 gram increments between 1980-81 when infants with major medical problems were hospitalized in outside facilities (mortality rate=100%) and 1982-83 when INIC care was provided completely within the facility. Overall survival increased from 37.9% (n=504) in 1980-81 to 70.5% (n=581) in 1982-83 (p<.005). A statistically significant improvement in survival occurred in all birth weight categories. Survival in infants ≤1250 grams improved least [5.6% (n=89) to 22.9% (n=109) (p<.005)]. Infants between 1251 and 2000 grams benefitted most [40% (n=279), 74.8% (n=322), p<.005]. Average daily cost for the entire period of hospitalization was $7.75 vs. $1,033 for a comparable population in our own institution. These data indicate that the survival of LBW infants, free from significant medical problems (HMD, asphyxia, cong. anom.), can be improved with INIC at a low cost. However, the application of this type of program must still be considered in relation to the long-term health goals and available financial resources in non-industrialized countries.

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