To compare cost effectiveness of 'Kangaroo Ward Care' with 'Intermediate intensive care' in stable very low birth weight infants (birth weight < 1100 grams): A randomized control trial

Abstract

Background: To compare cost effectiveness of 'Kangaroo Ward Care' with 'Intermediate Intensive Care' in stable very low birth weight infants (birth weight < 1100 g). Methods: This is the secondary analysis of the study in which we have analysed the cost effectiveness of 'Kangaroo ward care' (KWC) with 'Intermediate Intensive Care' (IIC). In this randomized control trial 141 infants (less than 1100 g and ≤ 32 weeks at birth) were enrolled, 71 were randomized to KWC group and 70 to IIC group, once the infant reached a weight of 1150 g. Infants randomized to KWC group were shifted to the Kangaroo ward immediately after randomization. Infants randomized to IIC group were shifted to the Kangaroo ward once the infant reached 1250 g. Results: Cost incurred by the patient in both the groups from the time of randomization to hospital discharge was calculated. The hospital costs were determined by "top-down" accounting methods and out of pocket expenditure of parents from standard "bottom-up" cost-accounting methods. There was significant reduction in neonatal charges in KWC group post-randomization {41591.9 ± 21712.8 INR vs 75388.8 ± 25532.2 INR; p < 0.001}). The separate "top-down" and "bottom-up" cost analysis showed that there was significant reduction of hospital and parents expenditure in KWC group when compared to IIC group (p < 0.001). There was significant saving of around 33800 INR (USD) in the KWC group for each patient. Conclusion: Initiating early shifting to Kangaroo ward is cost effective intervention and have huge monetary implication in resource poor countries. (CTRI/2014/05/004625, retrospectively registered, Registered on: 26/05/2014). Clinical trial registration: Clinical trial registry of India CTRI/2014/05/004625 (http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=7640&EncHid=&userName=CTRI/2014/05/004625) Registered on: 26/05/2014. Date of enrolment of the first participant to the trial: 13/11/2013.