cost of neonatal abstinence syndrome
Winkelman, MD, MSc, Hennepin County Medical Center, 701 Park Ave, S2.309, Minneapolis, MN 55415. OBJECTIVES: To provide an estimate on the most recent burden of neonatal abstinence syndrome (NAS) in the United States. Between 2011 and 2014, mean hospital costs for an infant with NAS covered by Medicaid were over fivefold higher than for an infant without NAS ($19 340 per birth vs $3700 per birth; P < .001). All Rights Reserved. Average LOS for morphine-treated newborns decreased from 16.9 to 12.3 days, average hospital costs per treated infant decreased from $19 737 to $8755, and costs per at-risk infant dropped from $11 000 to $5300. Center for Medicare and Medicaid Services, Reducing Early Elective Deliveries in Medicaid and CHIP. For these reasons, Congress called on the Government Accountability Office to report “the proportion of children born in the United States with NAS who are eligible for medical assistance under State Medicaid programs…and the costs associated with coverage under such programs.”10 However, the subsequent Government Accountability Office report was largely based on qualitative data, because little quantitative data are available to guide such an overview.11. Among 28 states with publicly available data in HCUP during 1999–2013, the overall NAS incidence increased 300%, from 1.5 per 1,000 hospital births in 1999, to 6.0 per 1,000 hospital births in 2013. 95 infants identified were exposed to opioid agonist drugs, or those used to help reduce the effects of NAS while the mother is in substance abuse treatment prior to birth. Caring for opioid-dependent pregnant women: prenatal and postpartum care considerations. Why do you think the costs are so high? Our study was exempt from human subjects review per the Minneapolis Medical Research Foundation’s policy on de-identified data sets. The Cost of Neonatal Abstinence Syndrome (NAS) May 21, 2015 pacerecovery Leave a comment. Neonatal abstinence syndrome rates were highest among Medicaid-covered births (12.3 per 1000) and those without insurance (7.0 per 1000). By 2014, 14.4 per 1000 hospital births (95% CI, 12.9–15.8), or 1.4% of all Medicaid-financed births, were affected by NAS. METHODS: The 2016 Kids’ Inpatient Database, provided by the Healthcare Cost and Utilization Project and Agency for Healthcare Research and Quality and its partners, was used to identify patients with NAS in the United States. In 2014, $563M were spent on costs for treatment of NAS/NOWS; the majority of these charges (82%) were paid by state Medicaid programs, reflecting the greater tendency of mothers using opioids during pregnancy to be from lower-income communities. Rates of neonatal abstinence syndrome and maternal opioid-related diagnoses have grown significantly between 2010 and 2017, with both national and state-level increases, according to … In each time period we examined, infants with NAS who were covered by Medicaid had hospital stays that were significantly longer than infants without NAS who were covered by Medicaid or infants with NAS who were covered by private insurance (Table 2). Follow Facebook Twitter LinkedIn Subscribe RSS Feeds Newsletters. Rooming-in compared with standard care for newborns of mothers using methadone or heroin. [4]: http://www.neomed.edu/academics/medicine/departments/family-medicine/community-outreach/current-concepts-in-integrated-health-care/copy_of_BackesNeonatalAbstinenceSlides.pdf We first calculated the annual national incidence of NAS among all infants per 1000 hospital births. Neonatal Abstinence Syndrome (NAS) Among Newborn Hospitalizations Use the interactive map and legend below to examine the rate of NAS-related newborn hospitalizations by State. Meeting nutrition needs with on-demand feeding and avoid unnecessary waking. Rooming-in to treat neonatal abstinence syndrome: improved family-centered care at lower cost. Placing the newborn in a dark, quiet room with minimal disruption, sleep protection and pacifier use. Although opioids have been used to treat neonatal abstinence syndrome (NAS), the safest and most effective pharmacologic treatment has not … Proportion of birth-related hospital costs due to NAS among infants who were enrolled in Medicaid. The mean cost for an infant with NAS was significantly higher than for an infant without NAS. Thank you for your interest in spreading the word on American Academy of Pediatrics. The Journal of Addiction Medicine suggests that the cost of treatment for babies born with Neonatal Abstinence Syndrome (NAS) has increased dramatically [1]. Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Medicaid was the primary payer for 73.7% (95% CI, 68.9%–77.9%) of NAS-related births in 2004 and 82.0% (95% CI, 80.5%–83.5%) of NAS-related births in 2014. Conclusion: The incidence of neonatal abstinence syndrome is increasing in the United States, and carries an enormous burden in terms of hospital days and costs. Problem. Additionally, pregnancy is often a motivating and therefore opportune time for a woman to address her substance use disorder and pursue recovery. The impact of pharmacologic treatment on hospital use is not well established. Clinical presentation, assessment, treatment Authors of future work should evaluate factors that contribute to differences in transfer rates and length of stay among infants with NAS to identify opportunities for care improvement and cost savings. The NAS … Libby is also trained in Family Based Therapy (FBT) to work with children-young adults to treat eating disorders. NEONATAL ABSTINENCE SYNDROME—A GROWING CRISIS. © Copyright 2021 Addiction Hope. Neonatal Abstinence Syndrome Risks and Side Effects Prescription opiate misuse is one of the main causes of NAS, and also an epidemic throughout the country. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Improving affordable health insurance coverage for low-income women before pregnancy would expand access to substance use disorder treatment and could reduce NAS-related morbidity and costs. [ Read article. The number of US hospital admissions involving neonatal abstinence syndrome increased more than fourfold between the years 2003 and 2012. Characteristics and trends among births impacted by NAS were examined by using univariate statistics and logistic regression. The cost of opioid use during pregnancy: A fourfold rise in US hospital admissions for neonatal abstinence syndrome from 2003 to 2012. Use of opioids during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome or neonatal opioid withdrawal syndrome (NAS/NOWS). Mean inflation-adjusted hospital costs for infants with NAS covered by Medicaid increased 26% between 2004 and 2006 and 2011 and 2014 ($15 350 vs $19 340; P < .001; Table 2). Withdrawal symptoms most commonly occur 48-72 hours after birth and include tremors, hyperactive reflexes, seizures, excessive or high-pitched crying, irritability, yawning, stuffy nose, sneezing, sleep disturbances, poor feeding and/or sucking, vomiting, loose stools, dehydration, poor weight gain, increased sweating, temperature instability, and fever [8]. Each year, the total costs for treating NAS increased dramatically, the article reports. We compared the rate of hospital transfer to another facility, mean length of stay, and mean cost of birth hospitalization among infants with NAS who were enrolled in Medicaid to infants without NAS who were enrolled in Medicaid and to infants with NAS who were enrolled in private insurance. ScienceDaily … NIS data are aggregated from hospital discharge information and reflect coding practices in which misclassification bias is possible. The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. The ultimate goal of NAS treatment is to stop showing signs of withdrawal, feeding and sleeping well, weight gain, and to maintain stable withdrawal scores with little, if no support. From 2000 to 2012, there was an estimated 21, 732 infants born with NAS, equally 1 baby born with NAS every 25 minutes [2]. Between 2004 and 2014, the incidence of NAS in the United States increased from 1.5 per 1000 hospital births (95% CI, 1.2–1.9) to 8.0 per 1000 hospital births (95% CI, 7.2–8.7), a more than fivefold increase (Fig 1). Ultimately, a public health approach that targets patient-, family-, and community-level factors will be necessary to prevent women from developing opioid use disorders.30 Individual level predictors of opioid use disorders include mental health disorders and preexisting substance use disorders.31 Screening, referral, and treatment for these conditions may reduce the incidence of opioid use disorders among reproductive-age women. ; (2) What are the characteristics and health care use patterns of infants with NAS who were enrolled in Medicaid compared with infants without NAS who were enrolled in Medicaid and infants with NAS who were enrolled in private insurance?