The Impact of Prenatal Exposure to Cocaine on Newborn Costs and Length of Stay

Theodore Joyce, Andrew D. Racine, Sandra McCalla, Hassan Wehbeh

NBER Working Paper No. 4673
Issued in March 1994
NBER Program(s):Health Economics

This paper determines newborn costs and lengths of stay attributable to prenatal exposure to cocaine and other illicit drugs, using as a data source all parturients who delivered at a large municipal hospital in New York City between November 18, 1991 and April 11, 1992. We performed a cross-sectional analysis in which multivariate, loglinear regressions were used to analyze differences in costs and length of stay between infants exposed and unexposed prenatally to cocaine and other illicit drugs adjusting for maternal race, age, prenatal care, tobacco, parity, type of delivery, birth weight, prematurity, and newborn infection. Urine specimens, with linked obstetric sheets and discharge abstracts provided information on exposure, prenatal behaviors, costs, length of stay and discharge disposition. Our principal findings show that infants exposed to cocaine and some other illicit drug stay approximately 7 days longer at a cost of $7,731 more than infants unexposed. Approximately 60 percent of these costs are indirect, the result of adverse birth outcomes and newborn infection. Hospital screening as recorded on discharge abstracts substantially underestimates prevalence at delivery, but overestimates its impact on costs.

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Document Object Identifier (DOI): 10.3386/w4673

forthcoming, Health Services Research, June 1995.

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