Publications & Reports

Preterm birth and total healthcare use and costs in the first five years of life: a population-based study.

Yu S, Lui K, GFiebig D, Travadi J, Homer CS, Sinclair L, Scarf V, Viney R
PhD, University of Technology; Faculty of Health, Centre for Health Economics Research and Evaluation. Electronic address: [email protected]


OBJECTIVES: To investigate the relationship between preterm birth and hospital / out-of-hospital care and costs over the first five years of life. STUDY DESIGN: Birth data from a population-based cohort of 631,532 infants born between 2007 and 2013 were linked probabilistically with data on hospitalisations, primary and secondary care, and the use of medicines. We analysed the distribution of healthcare use and public healthcare costs for infants that survived at least five years, comparing the outcomes of extremely preterm (< 28 weeks' gestation), very preterm (28-32 weeks), moderate to late preterm (32-37 weeks), and term infants (at least 37 weeks). A linear regression model was used to investigate the effect of preterm birth on these outcomes, controlling for important confounders including pregnancy and birth complications, neonatal morbidity, survival, and maternal socioeconomic characteristics. RESULTS: Preterm birth has a statistically significant and economically relevant effect on healthcare use and costs in the first five years of life. Compared with a term infant, preterm infants born 32-36 weeks, 28-32 weeks, and < 28 weeks, respectively, had an average: 7.0 (std.err.=0.06), 41.6 (0.18), and 68.7 (0.35) days more hospital days; 3.1 (0.04), 11.0 (0.13) and 13.2 (0.25) more outpatient specialist physician visits; and five-year public healthcare costs which were 1.2 (<0.01), 6.8 (0.01), and 10.9 (0.02) times higher. Preterm infants also had statistically significant higher levels of GP visits and use of medicines. CONCLUSIONS: Higher levels of accessible care is needed for preterm infants across healthcare settings, and over a sustained period of time. As our understanding of the impact of preterm birth on long term clinical outcomes continues to improve, clinicians and policymakers should develop an accurate recognition of these needs for appropriate resource allocation towards research priorities and early intervention strategies.

Link to publisher’s web site


  • Journal: The Journal of Pediatrics
  • Published: 16/01/2023
  • Volume: Epub ahead of print