Authors:
Chambers GM, Lee E, Hoang VP, Hansen M, Bower C, Sullivan EA
Authors notes:
Human Reproduction. 2013;29(3):601-610
Keywords:
Assisted reproduction technologies, cost analysis, hospital admissions, singletons, childhood outcomes
Abstract:
Do singletons conceived following assisted reproduction technologies (ARTs) have significantly different hospital utilization, and therefore costs, compared with non-ART children during the first 5 years of life?
Singletons are at greater risk of adverse perinatal outcomes compared with non-ART singletons.
Long-term physical and mental health outcomes of ART singletons are generally reassuring. There is a scarcity of information on health service utilization and the health economic impact of ART conceived children.
Overall, ART singletons had a significantly longer length of stay during the birth-admission and a 20% increased risk of being admitted during the first 5 years of life.
The average adjusted difference in hospital admission costs up to 5 years of age was $2490, with most of the additional cost occurring during the birth-admission ($1473).
The independent residual cost associated with ART conception was $342 during the birth-admission and an additional $548 up to 5 years of age, indicating that being conceived as an ART child predicts not only higher birth-admission costs but excess costs to at least 5 years of age.
Clinicians and patients should be aware of the risk of poorer perinatal outcomes and increased hospitalization of ART singletons compared with non-ART singletons.
These differences are significant enough to affect health-care resource consumption, but are substantially and significantly less than those associated with ART multiple birth infants.
Understanding the short- and long-term health services and economic impact of ART is important for setting the research agenda in ART, for informing economic evaluations of infertility and treatment strategies, and for providing an important input to clinical and administrative decision making.