Özet:

Background: Developments in the field of perinatal and neonatal care have allowed a greater number of premature or risky infants to survive. Especially premature babies, because of the long length of stay in hospital Neonatal Intensive Care Unit (NICU) 's are increasing their occupancy rates. Neonatal intensive care diseases, in terms of costs constitute the largest group of hospitalization. In this study, we aimed to determine the cost of the patients in NICU, to determine the factors that affect the cost and to set new targets for what can be done to reduce the cost. Material and Methods: The data of 738 patients who were admitted to the NICU between January 1st, 2009 and December 31st, 2009 and were followed up and treated were evaluated retrospectively. The cost analysis of all obtained data was performed. Results: 398 (53.9%) of the 738 patients were male and 340 (46.1%) were female. In terms of cost, the average daily cost of care for a baby with a birth weight between 750-999 grams was 799.16 TL, 650.76 TL for babies 1000-1250 g, 448.30 TL for babies 1250-1499 g, 361.64 TL for babies 1500-2499 g, 312.55 TL for babies 2500-4000 g and 308.12 TL for those >4000 g. When the cost according to gestational week is evaluated; a baby with less than 28 weeks were found to be 805.89 TL, 28 to 31 weeks 534.17 TL, 32 to 36 weeks 400.23 TL, 35 to 37 weeks 385.97 TL and 38 weeks’ or longer 302.28 TL. As birth weight and gestational week increased, hospitalization time and total daily average costs decreased (p <0.05). Total daily average cost of patients with respiratory distress syndrome (RDS), cyanotic congenital heart diseases (CCHDs), acyanotic congenital heart diseases (CHDs), early neonatal sepsis, congenital pneumonia, transient tachypnea of the newborn (TTN), meconium aspiration syndrome (MAS), perinatal asphyxia and fetal distress was found to be high (p <0.05). In our study, the survival rate of infants under <1500 g was 81.4% and <1000 g was 36.3%. According to gestational week, the survival rate of less than 28 weeks infants was 39.5%. Conclusion: We found that gestational week, birth weight, RDS, fetal distress, asphyxia, CCHDs, acyanotic CHDs, TTN, early neonatal sepsis, congenital pneumonia and MAS were the strongest determinants of hospital stay and cost. It was observed that the duration of hospital stay and cost increased and the survival rates of the patients decreased especially as the gestational week and birth weights of the patients hospitalized in the NICU decreased. As a result, the most effective way to reduce the cost of the NICU was to prevent premature birth.

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