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Resource utilization patterns using non-invasive ventilation in neonates with respiratory distress syndrome

Journal of Perinatology volume 38, pages 850–856 (2018)Cite this article

Subjects

Abstract

Objectives

To describe the frequency of non-invasive ventilation (NIV) and endotracheal intubation use in neonates diagnosed with respiratory distress syndrome (RDS); to describe resources utilization (length of stay (LOS), charges, costs) among NIV and intubated RDS groups.

Study design

Retrospective study from the national Kid’s Inpatient Database of the Healthcare Cost and Utilization Project, for the years 1997–2012. Propensity scoring and multivariate regression analysis used to describe differences.

Results

A total of 595,254 out of 42,912,090 cases were identified with RDS. There was an increase in NIV use from 6% in 1997 to 17% in 2012. After matching, patients receiving NIV only were associated with shorter LOS: (95%CI) 25 (25.3,25.7) vs. 35 (34.2,34.9) days, decreased costs: ($/1k) 46.1 (45.5,46.8) vs. 65.0 (64.1,66.0), decreased charges: 130.3 (128.6,132.1) vs. 192.1 (189.5,194.6) compared to intubated neonates.

Conclusion

There was a three-fold increase in NIV use within the 15-year study period. NIV use was associated with decreased LOS, charges and costs compared to intubated patients.

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Funding

Dr. AL is supported by the National Center for Advancing Translational Science (NCATS) of the U.S. National Institutes of Health (KL2TR001854).

Author contributions

Mr. TAC and Dr. AL made substantial contributions to designing the study, analyzing the data, and interpreting the results, and wrote the first draft of the manuscript. Dr. AL made substantial contributions to designing the study, analyzing the data, and interpreting the results. Ms. LF wrote the first draft of the manuscript. Drs. NI, TAS, AG, PSF, and RR also assisted in interpreting the results and revising the manuscript. All authors reviewed and approved of the final version of the manuscript.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Fetal and Neonatal Institute, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Thomas A. Chavez, Ashwini Lakshmanan, Lizzette Figueroa, Narayan Iyer, Theodora A. Stavroudis, Arlene Garingo, Philippe S. Friedlich & Rangasamy Ramanathan

  2. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States

    Ashwini Lakshmanan

  3. Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States

    Ashwini Lakshmanan

  4. Division of Neonatology, Department of Pediatrics, LAC USC Medical Center, University of Southern California, Los Angeles, CA, USA

    Rangasamy Ramanathan

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  1. Thomas A. Chavez
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  2. Ashwini Lakshmanan
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  3. Lizzette Figueroa
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Corresponding author

Correspondence to Ashwini Lakshmanan.

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Chavez, T.A., Lakshmanan, A., Figueroa, L. et al. Resource utilization patterns using non-invasive ventilation in neonates with respiratory distress syndrome. J Perinatol 38, 850–856 (2018). https://doi.org/10.1038/s41372-018-0122-y

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