Medicaid Healthcare Expenditures for Infants with Birth Defects Potentially Related to Zika Virus Infection in North Carolina, 2011-2016

Overview

Journal Birth Defects Res

Specialties Reproductive Medicine
Toxicology

Date 2022 Jan 5

PMID 34984857

Citations 1

Authors

Kristin Bergman

Nina E Forestieri

Vito L Di Bona

Scott D Grosse

Cynthia A Moore

Affiliations

Soon will be listed here.

Abstract

Background: In 2016, Zika virus (ZIKV) was recognized as a human teratogen. North Carolina (NC) had no local transmission of ZIKV but infants with relevant birth defects, including severe brain anomalies, microcephaly, and eye abnormalities, require specialized care and services, the costs of which have not yet been quantified. The objective of this study is to examine NC Medicaid healthcare expenditures for infants with defects potentially related to ZIKV compared to infants with no reported defects.

Methods: Data sources for this retrospective cohort study include NC birth certificates, Birth Defects Monitoring Program data, and Medicaid enrollment and paid claims files. Infants with relevant defects were identified and expenditure ratios were calculated to compare distributions of estimated expenditures during the first year of life for infants with relevant defects and infants with no reported defects.

Results: This analysis included 551 infants with relevant defects and 365,318 infants with no reported defects born 2011-2016. Mean total expenditure per infant with defects was $69,244 (median $30,544) for the first year. The ratio of these expenditures relative to infants with no reported defects was 14.5. Expenditures for infants with select brain anomalies were greater than those for infants with select eye abnormalities only.

Conclusions: Infants with defects potentially related to ZIKV had substantially higher Medicaid expenditures than infants with no reported defects. These results may be informative in the event of a future outbreak and are a resource for program planning related to care for infants in NC.

Citing Articles

Outcomes up to age 36 months after congenital Zika virus infection-U.S. states.

Neelam V, Woodworth K, Chang D, Roth N, Reynolds M, Akosa A Pediatr Res. 2023; 95(2):558-565.

PMID: 37658124 PMC: 10913023. DOI: 10.1038/s41390-023-02787-9.

References

Peterson C, Dawson A, Grosse S, Riehle-Colarusso T, Olney R, Tanner J . Hospitalizations, costs, and mortality among infants with critical congenital heart disease: how important is timely detection?. Birth Defects Res A Clin Mol Teratol. 2013; 97(10):664-72. PMC: 4473256. DOI: 10.1002/bdra.23165. View

Ireys H, Anderson G, Shaffer T, Neff J . Expenditures for care of children with chronic illnesses enrolled in the Washington State Medicaid program, fiscal year 1993. Pediatrics. 1997; 100(2 Pt 1):197-204. DOI: 10.1542/peds.100.2.197. View

Grosse S, Waitzman N, Yang N, Abe K, Barfield W . Employer-Sponsored Plan Expenditures for Infants Born Preterm. Pediatrics. 2017; 140(4). PMC: 6029853. DOI: 10.1542/peds.2017-1078. View

Arth A, Tinker S, Simeone R, Ailes E, Cragan J, Grosse S . Inpatient Hospitalization Costs Associated with Birth Defects Among Persons of All Ages - United States, 2013. MMWR Morb Mortal Wkly Rep. 2017; 66(2):41-46. PMC: 5657658. DOI: 10.15585/mmwr.mm6602a1. View

Shewale J, Ganduglia Cazaban C, Waller D, Mitchell L, Langlois P, Agopian A . Microcephaly inpatient hospitalization and potential Zika outbreak in Texas: A cost and predicted economic burden analysis. Travel Med Infect Dis. 2019; 30:67-72. DOI: 10.1016/j.tmaid.2019.01.001. View

Hsu W, Sommerhalter K, McGarry C, Farr S, Downing K, Lui G . Inpatient admissions and costs for adolescents and young adults with congenital heart defects in New York, 2009-2013. Birth Defects Res. 2020; 113(2):173-188. PMC: 7855404. DOI: 10.1002/bdr2.1809. View

Pinto N, Waitzman N, Nelson R, Minich L, Krikov S, Botto L . Early Childhood Inpatient Costs of Critical Congenital Heart Disease. J Pediatr. 2018; 203:371-379.e7. PMC: 11104566. DOI: 10.1016/j.jpeds.2018.07.060. View

Basseri B, Kianmahd B, Roostaeian J, Kohan E, Wasson K, Basseri R . Current national incidence, trends, and health care resource utilization of cleft lip-cleft palate. Plast Reconstr Surg. 2011; 127(3):1255-1262. DOI: 10.1097/PRS.0b013e3182043af6. View

Simeone R, Oster M, Hobbs C, Robbins J, Collins R, Honein M . Population-based study of hospital costs for hospitalizations of infants, children, and adults with a congenital heart defect, Arkansas 2006 to 2011. Birth Defects Res A Clin Mol Teratol. 2015; 103(9):814-20. PMC: 4565745. DOI: 10.1002/bdra.23379. View

10.

Phibbs C, Schmitt S, Cooper M, Gould J, Lee H, Profit J . Birth Hospitalization Costs and Days of Care for Mothers and Neonates in California, 2009-2011. J Pediatr. 2018; 204:118-125.e14. PMC: 6309642. DOI: 10.1016/j.jpeds.2018.08.041. View

11.

Cassell C, Meyer R, Daniels J . Health care expenditures among Medicaid enrolled children with and without orofacial clefts in North Carolina, 1995-2002. Birth Defects Res A Clin Mol Teratol. 2008; 82(11):785-94. DOI: 10.1002/bdra.20522. View

12.

Ouyang L, Grosse S, Armour B, Waitzman N . Health care expenditures of children and adults with spina bifida in a privately insured U.S. population. Birth Defects Res A Clin Mol Teratol. 2007; 79(7):552-8. DOI: 10.1002/bdra.20360. View

13.

Cassell C, Grosse S, Thorpe P, Howell E, Meyer R . Health care expenditures among children with and those without spina bifida enrolled in Medicaid in North Carolina. Birth Defects Res A Clin Mol Teratol. 2011; 91(12):1019-27. DOI: 10.1002/bdra.22864. View

14.

Razzaghi H, Oster M, Reefhuis J . Long-term outcomes in children with congenital heart disease: National Health Interview Survey. J Pediatr. 2014; 166(1):119-24. PMC: 4378575. DOI: 10.1016/j.jpeds.2014.09.006. View

15.

Weiss J, Kotelchuck M, Grosse S, Manning S, Anderka M, Wyszynski D . Hospital use and associated costs of children aged zero-to-two years with craniofacial malformations in Massachusetts. Birth Defects Res A Clin Mol Teratol. 2009; 85(11):925-34. DOI: 10.1002/bdra.20635. View

16.

Boulet S, Grosse S, Honein M, Correa-Villasenor A . Children with orofacial clefts: health-care use and costs among a privately insured population. Public Health Rep. 2009; 124(3):447-53. PMC: 2663882. DOI: 10.1177/003335490912400315. View

17.

Neff J, Sharp V, Muldoon J, Graham J, Myers K . Profile of medical charges for children by health status group and severity level in a Washington State Health Plan. Health Serv Res. 2004; 39(1):73-89. PMC: 1360995. DOI: 10.1111/j.1475-6773.2004.00216.x. View

18.

Dunn A, Grosse S, Zuvekas S . Adjusting Health Expenditures for Inflation: A Review of Measures for Health Services Research in the United States. Health Serv Res. 2016; 53(1):175-196. PMC: 5785315. DOI: 10.1111/1475-6773.12612. View

19.

Villar J, Ismail L, Victora C, Ohuma E, Bertino E, Altman D . International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014; 384(9946):857-68. DOI: 10.1016/S0140-6736(14)60932-6. View

20.

Honein M, Kirby R, Meyer R, Xing J, Skerrette N, Yuskiv N . The association between major birth defects and preterm birth. Matern Child Health J. 2008; 13(2):164-75. PMC: 11669608. DOI: 10.1007/s10995-008-0348-y. View