Researchers at Beth Israel Deaconess Medical Center (BIDMC) said that better accessibility to 'cool caps' for newborns suffering form asphyxia at birth may reduce costs of treatments for a lifetime.
The research team, led by Gray and John Zupancic, MD, ScD, Department of Neonatology at BIDMC and Division of Newborn Medicine, Harvard Medical School examined potential health benefits of making the cooling devices more widely available.
A computer-based modeling technique known as discrete event simulation was used to demonstrate that better availability and placement of "CoolCaps" within a regional healthcare system could lead to a 23 pct reduction in the number of newborns likely to develop permanent damage from hypoxic-ischemic encephalopathy (HIE).
HIE is a form of asphyxia that damages the central nervous system and is caused by a lack of oxygen and blood flow to the brain and can lead to cerebral palsy, mental retardation, blindness or deafness. One in 1,000 out of more than four million newborns treated in neonatal intensive care units (NICUs) each year, suffer from HIE.
Newborns' body temperature can be decreased by three to four degrees Celsius by using a selective head cooling (SHC) device within a few hours of birth, and that may control or rule off any damage to the newborn's brain.
"Our analyses confirm that making more cooling caps more available in hospitals can save lives and achieve significant reductions in severe neurodevelopment impairment in babies. Importantly, these improvements can be achieved while lowering the costs of care for this group of critically ill infants," said study co-author James Gray, MD, MS, Department of Neonatology at BIDMC, and the Division of Newborn Medicine at Harvard Medical School.."
This simulation, which is currently used in other industries, such as manufacturing, airport and shipping operations, has been applied to healthcare only recently.
The care and outcomes of all infants born in Massachusetts over a one-year period (approximately 76,000) was modeled and then the researchers assessed how to distribute the devices to the 24 NICUs throughout the area.
"Neonatal intensive care is highly regionalized, and as a result of the increased distances, access to life-saving technology may not be timely for all patients. By borrowing innovative problem-solving techniques from other industries, we can establish how to achieve improved efficiency and decreased costs across complex health care systems," explained Zupancic.
It was shown by the Harvard researchers that the treatment of HIE-related disabilities costs the health care system $900,000 per patient, which includes medical and non-medical costs linked with children requiring assistance for the rest of their lives.
The researchers tested several scenarios with different location and number of SHC devices across the state.
Specific data was gathered on ambulance transportation times and infant health, as well as economic data on hospital, physician, and treatment costs from the 2006 Center for Medicare and Medicaid Services' Hospital Cost Report.
The study appeared in the recent issue of Pediatrics.