Rising public costs of preterm infant hospitalization in South Korea from a nationwide observational study

Abstract Despite the decline in the overall birth rate, increasing preterm births and associated medical costs pose a national concern. We analyze hospitalization costs covered by national public insurance for preterm infants. Population-based data, obtained from the National Health Insurance Servic...

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Main Authors: Ji Young Lee, Joonsik Park, Myeongjee Lee, Minkyung Han, Sung Min Lim, Jee Yeon Baek, Ji-Man Kang, Min Soo Park, Inkyung Jung, Jong Gyun Ahn
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-98868-2
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author Ji Young Lee
Joonsik Park
Myeongjee Lee
Minkyung Han
Sung Min Lim
Jee Yeon Baek
Ji-Man Kang
Min Soo Park
Inkyung Jung
Jong Gyun Ahn
author_facet Ji Young Lee
Joonsik Park
Myeongjee Lee
Minkyung Han
Sung Min Lim
Jee Yeon Baek
Ji-Man Kang
Min Soo Park
Inkyung Jung
Jong Gyun Ahn
author_sort Ji Young Lee
collection DOAJ
description Abstract Despite the decline in the overall birth rate, increasing preterm births and associated medical costs pose a national concern. We analyze hospitalization costs covered by national public insurance for preterm infants. Population-based data, obtained from the National Health Insurance Service (NHIS), which is operated by the Health Insurance Review and Assessment Service, were used for the study. Preterm births from January 1, 2008 to December 31, 2020 were included, using International Classification of Diseases and Related Health Problems, 10th edition (P07.2, extremely preterm < 28 weeks gestational age, P07.3, non-extremely preterm). The primary outcomes related to cost from the first hospitalization due to preterm births and medication, and laboratory, radiological, and functional tests by gestational age and birth weight. Additionally, we assessed the readmission rates of preterm infants and the associated medical costs. A total of 5,312,886 live infants were born, of which 90,575 were claimed as preterm birth hospitalization. The total medical cost per patient increased almost three-fold from $7,390.90 to $20,209.59 from 2008 to 2020; for the extremely preterm group, it increased four-fold ($13,961.03 to $55,984.47). The readmission rate within 90 days of discharge was 62.5%; however, a greater proportion of the extremely preterm, as compared to the non-extremely preterm (16.1% vs. 8.32%, P < 0.001) group was readmitted within 30 days. The extremely preterm group also incurred higher costs associated with readmission (mean $4293.8 vs. $2975.4, P < 0.001). This study reveals not only the increase in preterm birth rate in South Korea, but also in the associated medical costs. Further attention should be paid to efficient resource allocation at the national level to relieve the medical burden of preterm births.
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spelling doaj-art-3b064c81aebd4af69e78bb1e985b6b9d2025-08-20T03:14:06ZengNature PortfolioScientific Reports2045-23222025-04-011511710.1038/s41598-025-98868-2Rising public costs of preterm infant hospitalization in South Korea from a nationwide observational studyJi Young Lee0Joonsik Park1Myeongjee Lee2Minkyung Han3Sung Min Lim4Jee Yeon Baek5Ji-Man Kang6Min Soo Park7Inkyung Jung8Jong Gyun Ahn9Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of MedicineDivision of Neonatology, Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of MedicineBiostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of MedicineBiostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of MedicineDepartment of Pediatrics, Severance Children’s Hospital, Yonsei University College of MedicineDepartment of Pediatrics, Severance Children’s Hospital, Yonsei University College of MedicineDepartment of Pediatrics, Severance Children’s Hospital, Yonsei University College of MedicineDepartment of Pediatrics, Severance Children’s Hospital, Yonsei University College of MedicineDivision of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of MedicineDepartment of Pediatrics, Severance Children’s Hospital, Yonsei University College of MedicineAbstract Despite the decline in the overall birth rate, increasing preterm births and associated medical costs pose a national concern. We analyze hospitalization costs covered by national public insurance for preterm infants. Population-based data, obtained from the National Health Insurance Service (NHIS), which is operated by the Health Insurance Review and Assessment Service, were used for the study. Preterm births from January 1, 2008 to December 31, 2020 were included, using International Classification of Diseases and Related Health Problems, 10th edition (P07.2, extremely preterm < 28 weeks gestational age, P07.3, non-extremely preterm). The primary outcomes related to cost from the first hospitalization due to preterm births and medication, and laboratory, radiological, and functional tests by gestational age and birth weight. Additionally, we assessed the readmission rates of preterm infants and the associated medical costs. A total of 5,312,886 live infants were born, of which 90,575 were claimed as preterm birth hospitalization. The total medical cost per patient increased almost three-fold from $7,390.90 to $20,209.59 from 2008 to 2020; for the extremely preterm group, it increased four-fold ($13,961.03 to $55,984.47). The readmission rate within 90 days of discharge was 62.5%; however, a greater proportion of the extremely preterm, as compared to the non-extremely preterm (16.1% vs. 8.32%, P < 0.001) group was readmitted within 30 days. The extremely preterm group also incurred higher costs associated with readmission (mean $4293.8 vs. $2975.4, P < 0.001). This study reveals not only the increase in preterm birth rate in South Korea, but also in the associated medical costs. Further attention should be paid to efficient resource allocation at the national level to relieve the medical burden of preterm births.https://doi.org/10.1038/s41598-025-98868-2PrematurityCostHealth insuranceHospitalizationPreterm birth
spellingShingle Ji Young Lee
Joonsik Park
Myeongjee Lee
Minkyung Han
Sung Min Lim
Jee Yeon Baek
Ji-Man Kang
Min Soo Park
Inkyung Jung
Jong Gyun Ahn
Rising public costs of preterm infant hospitalization in South Korea from a nationwide observational study
Scientific Reports
Prematurity
Cost
Health insurance
Hospitalization
Preterm birth
title Rising public costs of preterm infant hospitalization in South Korea from a nationwide observational study
title_full Rising public costs of preterm infant hospitalization in South Korea from a nationwide observational study
title_fullStr Rising public costs of preterm infant hospitalization in South Korea from a nationwide observational study
title_full_unstemmed Rising public costs of preterm infant hospitalization in South Korea from a nationwide observational study
title_short Rising public costs of preterm infant hospitalization in South Korea from a nationwide observational study
title_sort rising public costs of preterm infant hospitalization in south korea from a nationwide observational study
topic Prematurity
Cost
Health insurance
Hospitalization
Preterm birth
url https://doi.org/10.1038/s41598-025-98868-2
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