Cost of neonatal intensive care in a tertiary care center

Background: The number of neonatal intensive care units (NICUs) in India has increased substantially over the last decade; yet many more are required. Mere is limited information on the actual costs of setting up and running an NICU in India. Objective: Systematic and comprehensive calculation and analysis of the costs of neonatal intensive care in a tertiary care teaching hospital. Methods: The costs were compiled by studying the detailed records of various hospital departments and prospectively documenting the costs of drugs, consumables and investigations for a representative group of 30 babies. Results: The total cost of establishing a 16 bed level III tertiary care NICU was Rs 3.78 crore (Rs. 37.8 million, US$ 860,000) (2003). Equipment cost formed two-thirds of the establishment cost. The running cost of NICU care per patient per day was Rs 5450 (US$ 125). NICU and ancillary personnel salary comprised the largest proportion of the running costs. The average total cost of care for a baby < 1000 grams was Rs. 1,68,000 (US$ 3800), Rs. 88,300 (US$ 2000)for babies 1000-1250 g. and Rs. 41,700 (US$ 950)for those between 1250-1500 g. The family had to bear only 25%; rest was subsidized. Conclusions: Equipment and personnel salary form the biggest proportion of establishment and running costs. The costs of treatment for a baby in NICU should be seen in context with costs of other types of health care and the number of useful life-years gained.