Costs and end-of-life care in the NICU: Lessons for the MICU?

Journal of Law, Medicine and Ethics

Volumn 39, Issue 2, 2011, Pages 194-200

  Lantos, John D ^a   Meadow, William L ^b  

^a UNIVERSITY OF MISSOURI KANSAS CITY   (United States)

^b UNIVERSITY OF CHICAGO   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGED; ARTICLE; COST BENEFIT ANALYSIS; DEVELOPMENTAL DISORDER; ECONOMICS; HEALTH CARE COST; HUMAN; INFANT MORTALITY; INTENSIVE CARE UNIT; NEWBORN; NEWBORN INTENSIVE CARE; QUALITY ADJUSTED LIFE YEAR; TERMINAL CARE; UNITED STATES;

AGED; AGED, 80 AND OVER; COST-BENEFIT ANALYSIS; DEVELOPMENTAL DISABILITIES; HEALTH CARE COSTS; HUMANS; INFANT MORTALITY; INFANT, NEWBORN; INTENSIVE CARE UNITS; INTENSIVE CARE UNITS, NEONATAL; QUALITY-ADJUSTED LIFE YEARS; TERMINAL CARE; UNITED STATES;

EID: 79955813633     PISSN: 10731105     EISSN: 1748720X     Source Type: Journal    
DOI: 10.1111/j.1748-720X.2011.00588.x     Document Type: Article

References (33)

1. E. Korvenranta, M. Linna, and L. Rautava et al., "Hospital Costs and Quality of Life during 4 Years after Very Preterm Birth", Archives of Pediatric & Adolescent Medicine 164, no. 3 (2010): 657-663.
2. L. W. Doyle, "Victorian Infant Collaborative Study Group: Evaluation of Neonatal Intensive Care for Extremely Low Birth Weight Infants in Victoria over Two Decades: II. Efficiency", Pediatrics 113, no. 2 (2004): 510-514.
3. M. Eriksson, L. Bodin, O. Finnström, and J. Schollin, "Can Severity-of-Illness Indices for Neonatal Intensive Care Predict Outcome at 4 Years of Age?" Acta Paediatrica 91, no. 10 (2002): 1093-1100.
4. D. M. Cuttler and E. Meara, "The Technology of Birth: Is It Worth It?" Forum for Health Economics & Policy, Frontiers in Health Policy Research 3 (2000), available at (last visited February 22, 2011).
5. J. D. Lantos, M. Mokalla, and W. Meadow, "Resource Allocation in Neonatal and Medical ICUs: Epidemiology and Rationing at the Extremes of Life", American Journal of Respiratory and Critical Care Medicine 156, no. 1 (1997): 185-189.
6. Health Resources and Services Administration, The Critical Care Workforce: A Report to Congress, 2003, available at (last visited February 22, 2011).
7. K. S. Lee, "Infant Mortality Decline in the Late 19th and Early 20th Centuries: The Role of Market Milk", Perspectives in Biology and Medicine 50, no. 3 (2007): 585-602.
8. D. J. Henderson-Smart, A. Wilkinson, and C. H. Raynes-Greenow, "Mechanical Ventilation for Newborn Infants with Respiratory Failure Due to Pulmonary Disease", Cochrane Database System Review 4 (2002): CD002770.
9. R. S. Duff and A. G. Campbell, "Moral and Ethical Dilemmas in the Special-Care Nursery", New England Journal of Medicine 289, no. 8 (1973): 890-894.
10. In Re Quinlan, 70 N.J. 10, 355 A.2d 647 (1976).
11. S. M. Lasswell, W. D. Barfield, R. W. Rochat, and L. Blackmon, "Perinatal Regionalization for Very Low-Birth-Weight and Very Preterm Infants: A Meta-Analysis", JAMA 304, no. 8 (2010): 992-1000.
12. A. A. Verhagen, A. Janvier, S. R. Leuthner, B. Andrews, J. Lagatta, A. F. Bos, and W. Meadow, "Categorizing Neonatal Deaths: A Cross-Cultural Study in the United States, Canada, and The Netherlands", Journal of Pediatrics 156, no. 1 (2010): 33-37.
13. H. Dolk, M. Loane, and E. Garne et al., "Trends and Geographic Inequalities in the Prevalence of Down Syndrome in Europe, 1980-1999", Revue d Épidémiologie et de Santé Publique 53, spec. no. 2 (2005): 2S87-S95.
14. K. S. Crider, R. S. Olney, and J. D. Cragan, "Trisomies 13 and 18: Population Prevalences, Characteristics, and Prenatal Diagnosis, Metropolitan Atlanta, 1994-2003", American Journal of Medical Genetics A 146, no. 4 (2008): 820-826.
15. S. V. Rasiah, A. K. Ewer, and P. Miller et al., "Antenatal Perspective of Hypoplastic Left Heart Syndrome: 5 Years On", Archives of Disease in Childhood Fetal and Neonatal Edition 93, no. 3 (2008): F192-F197.
16. J. D. Cragan, H. E. Roberts, and L. D. Edmonds et al., "Surveillance for Anencephaly and Spina Bifida and the Impact of Prenatal Diagnosis-United States, 1985-1994", MMWR CDC Surveillance Summary 44, no. 1 (1995): 1-13.
17. J. Singh, J. Lantos, and W. Meadow, "End-of-Life after Birth: Death and Dying in a Neonatal Intensive Care Unit", Pediatrics 114, no. 6 (2004): 1620-1626.
18. W. Meadow, "Epidemiology, Economics, and Ethics in the NICU: Reflections from 30 Years of Neonatology Practice", Journal of Pediatric Gastroenterology and Nutrition 45, Supp. 3 (2007): S215-S217.
19. B. Buchh, N. Graham, and B. Harris et al., "Neonatology Has Always Been a Bargain - Even When We Weren't Very Good at It", Acta Paediatrica 96, no. 4 (2007): 659-663.
20. J. E. Tyson, N. A. Parikh, J. Langer, C. Green, and R. D. Higgins, National Institute of Child Health and Human Development Neonatal Research Network, "Intensive Care for Extreme Prematurity - Moving beyond Gestational Age", New England Journal of Medicine 358, no. 14 (2008): 1672-1681.
21. J. Singh, J. Fanaroff, and B. Andrews et al., "Resuscitation in the 'Gray Zone' of Viability: Determining Physician Preferences and Predicting Infant Outcomes", Pediatrics 120, no. 3 (2007): 519-526.
22. J. Lagatta, B. Andrews, and L. Caldarelli et al., "Early NICu Therapy Improves Predictive Power for the Outcomes of Ventilated ELBW Infants", Journal of Pediatrics (in press, 2011).
23. W. L. Meadow, J. D. Lantos, T. Reimschisel, and M. Mokalla, "Distributive Justice across Generations: Epidemiology of ICU Care for the Very Young and the Very Old", Clinics in Perinatology 23, no. 3 (1996): 597-608.
24. W. Meadow, A. Pohlman, and L. Frain et al., "Power and Limitations of Daily Prognostications of Death in the MICU", Critical Care Medicine (in press, 2011).
25. W. Meadow, J. Hall, L. Frain, Y. Ren, A. Pohlman, S. Plesha-Troyke, W. Gresens, and J. Lantos, "Some Are Old, Some Are New: Life and Death in the ICU", Seminars in Perinatology 27, no. 6 (2003): 471-479.
26. L. M. Kopelman, "Disputes over Moral Standards Guiding Treatments for Imperiled Infants", Seminars in Perinatology 33, no. 2 (2009): 372-376.
27. C. Vavasseur, A. Foran, and J. F. Murphy, "Consensus Statements on the Borderlands of Neonatal Viability: From Uncertainty to Grey Areas", Irish Medical Journal 100 (2007): 561-564.
28. A. Janvier, I. Leblanc, and K. J. Barrington, "Nobody Likes Preemies: The Relative Value of Patients' Lives", Journal of Perinatology 28, no. 4 (2008): 821-826.
29. H. Wunsch, C. Guerra, A. E. Barnato, D. C. Angus, G. Li, and W. T. Linde-Zwirble, "Three-Year Outcomes for Medicare Beneficiaries Who Survive Intensive Care", JAMA 303, no. 5 (2010): 849-856.
30. A. E. Barnato, S. M. Albert, D. C. Angus, J. R. Lave, and H. B. Degenholtz, "Disability among Elderly Survivors of Mechanical Ventilation", American Journal of Respiratory and Critical Care Medicine (November 5, 2010).
31. D. Wilson-Costello, H. Friedman, and N. Minich et al., "Improved Neurodevelopmental Outcomes for Extremely Low Birth Weight Infants in 2000-2002", Pediatrics 119, no. 1 (2007): 37-45.
32. D. Hennessy, K. Juzwishin, D. Yergens, T. Noseworthy, and C. Doig, "Outcomes of Elderly Survivors of Intensive Care: A Review of the Literature", Chest 127, no. 10 (2005): 1764-174.
33. W. J. Ehlenbach, A. E. Barnato, and J. R. Curtis et al., "Epidemiologic Study of In-Hospital Cardiopulmonary Resuscitation in the Elderly", New England Journal of Medicine 361, no. 1 (2009): 22-31.