Objective Bronchopulmonary dysplasia (BPD) is associated with adverse clinical outcomes during the first two years of life. The objective of this study was to quantify the economic burden of BPD from birth to two years from the payer perspective.

Methods Retrospective cohort analysis using medical claims (1997 to 2007) from a database of over 90 US managed care plans covering nearly 52 million lives. Premature infants ⩽32 weeks or <2000 grams were identified by ICD-9-CM codes and stratified by BPD diagnosis. Paid claims, standardized to 2007 costs, were used to assess costs from birth through a two-year follow-up period. Adjusted cost and resource use estimates were obtained after controlling for relevant covariates using generalized linear models with a log link function and appropriate distribution.

Results A total of 5,135 premature infants meeting study criteria were identified, of which 810 (15.8%) had a BPD diagnosis. Infants with BPD incurred significantly higher mean adjusted total costs during the birth hospitalization ($92,657 versus $82,822, P<0.001) and significantly higher adjusted costs following discharge from the birth hospitalization through age two ($29,383 versus $16,911, P<0.001). In both cohorts, the majority of costs incurred during the follow-up period were from inpatient hospitalizations ($15,363 versus $5,240, P<0.001). The mean number of subsequent hospitalizations was significantly higher in infants with BPD (0.8 versus 0.6, P<0.001).

Conclusion Premature infants who develop BPD incur significantly higher costs during the first two years of life and have more subsequent hospitalizations than those who do not develop BPD.

Funding source: Ikaria.