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better understanding of the full scope of the growing economic burden of preterm birth in the United States.

The proportions of the total cost accounted for by each cost category mentioned above should be considered with caution, as the estimates reflect a higher degree of precision with respect to what can be most readily assessed for categories of cost that have drawn more extensive resources for their determination, such as early inpatient care, than for cost categories that pose greater methodological challenges for determination and that have received less attention, such as caregiver and maternal costs other than those involved with delivery.

While previous chapters in this report summarize and assess the literature on the causes and consequences of preterm birth, this chapter presents the results of new research undertaken by the Committee on the economic consequences of preterm birth, and places this research within the context of a select literature on the topic. A more systematic review of the literature on the cost of preterm birth can be found in Appendix D (Zupancic, 2006). Medical care costs in infancy for children born preterm, particularly those related to initial hospitalization, have received relatively extensive attention in the published literature compared with the amount of attention given to noninpatient and postinfancy medical care costs (Zupancic, 2006).

Based on the Committee’s estimates, the annual societal economic burden associated with preterm birth in the United States was at least $26.2 billion in 2005, or $51,600 per infant born preterm (Table 12-1). The referent for these estimates was the resources expended on full-term infants; that is, these costs are above and beyond what would have been expended had these infants been born at term. Nearly two-thirds of the societal cost was accounted for by medical care. The share that medical care services contributed to the total cost was $16.9 billion ($33,200 per preterm infant), with more than 85 percent of those medical care services delivered in infancy. Maternal delivery costs contributed another $1.9 billion ($3,800 per preterm infant). Early intervention services cost an estimated $611 million ($1,200 per preterm infant), whereas special education services associated with a higher prevalence of four disabling conditions including cerebral palsy (CP), mental retardation (MR), vision impairment (VI), and hearing loss (HL) among premature infants added $1.1 billion ($2,200 per preterm infant). Lost household and labor market productivity associated with those disabilities contributed $5.7 billion ($11,200 per preterm infant).

These new cost estimates for medical care received beyond infancy for those born preterm are among the first ever such estimates obtained in the



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