The Margins of
Stephen Kinsella** Dominic Trepel**
Fiona McElligott * Roy K Philip*
*Regional Maternity Hospital
**University of Limerick
What we did.
Question: How much did it cost to keep 1 ELBW
infant alive for 212 days in hospital?
Answer: 611,000 euros.
Method: calculation of total costs from highly
detailed data set gathered from patient,
painstaking attention to details of the case.
Marginal costs calculated as TC = €611,497,38, 1
week of extra life cost €8531.00, Fixed cost:
Conclusion: very precise data implies much larger
cost than other US/UK studies have found.
Our study examines the cost of care in the case of an
extremely low birth weight (ELBW) infant.
Birth at 24 weeks: the marginal case
Many procedures required to keep patient alive
212 days in hospital
Q: How much did this cost?
176 variables Data
17 different antimicrobials,
479 ‘antibiotic days’
95 ventilation days
83 radiological procedures including
47 X-rays, 1 MRI, 35 ultrasound scans
(head, abdomen, heart)
940 laboratory investigations
2 x National Neonatal Transport Transfer
Family’s Time, Equipment Maintenance,
Refurbishment, and more...
Assigned unit costs to chart variables.
Calculated Fixed, Variable, Total and
Marginal Costs daily as
T Ct Cost
= M Ct
Qt−1 Q: Extra
day of life
Day 19 Fungal Sepsis, Day 202
Transfer to Crumlin RSV Vaccination