Mike Nudelman/Business InsiderEmma Walton had an easy pregnancy.
She didn't feel as much movement as the books had led her to expect, and the fetus regularly passed ultrasounds and nonstress tests.
After many hours of labor at a local community hospital in northwest Pennsylvania, the baby appeared distressed and needed to be delivered by emergency cesarean section. "They pulled him out and there was no sound," Emma says. "You usually expect to hear a screaming baby and there was just nothing. Dead silence."
Baby Conrad was intubated and taken by ambulance 60 miles to a neonatal intensive care unit (NICU) in Erie. Emma's husband, Scott, traveled with him while Emma recovered from surgery. Conrad had been born with dangerously low muscle tone - "floppy," doctors say - and couldn't breathe on his own or swallow.
After a few days, when doctors still couldn't determine the cause of his symptoms, they referred him to the nationally acclaimed Children's Hospital of Pittsburgh.
The hospital, which opened its $625 million clinical and research campus in 2009, is one of a growing number of sumptuous new children's hospitals that combine state-of-the-art medical care with playrooms, whimsical decor, and extensive support services.
After genetic testing and a muscle biopsy, Conrad received a diagnosis of myotubular myopathy, a rare genetic disorder in which muscle cells do not form properly. It's a life-threatening condition, but by the end of six weeks in the NICU, Conrad could breathe without a ventilator, though his saliva still had to be suctioned regularly to prevent him from aspirating.
He received a surgical procedure so that he could be fed through a tube into his abdomen.
"A lot of the basic research out there was pretty grim," Emma says. "It was a lot to take in all at once."
Before bringing him home, Conrad's parents had to know how to suction him and how to use a pulse oximeter. They learned how to vacate air bubbles from syringes and how to administer his medications. They began to master the physics of enteral tube feeds.
Even cuddling Conrad, whose body Emma describes as "very much like a rag doll," required preparation and vigilance.
The Waltons brought Conrad home in May 2013, when he was 2 months old. A nurse stayed with them the first night. As Emma recalls, "We got up the next morning, and we were, like, 'OK, we've got this baby to take care of.'"
Bring In The Preemies In August 1963, three months before her husband was assassinated, Jackie Kennedy gave birth to a baby boy. Patrick Bouvier Kennedy was born five and a half weeks premature and weighed 4 pounds 10 ounces. He had lung disease, which is common among premature babies.
Patrick was rushed from Cape Cod to Boston Children's Hospital, where he died at 39 hours old.
New York Times
Baby Patrick's death helped to catalyze the then nascent field of neonatology, which has made miraculous strides over the past 50 years. A baby born in Patrick's condition today has almost a 100% survival rate. Indeed, babies born weeks earlier than Patrick, weighing less than 2 pounds, routinely survive without serious complications.
The breakthroughs are so impressive that one such baby, a child named Emalyn, occupied the cover of Time magazine last week, a tiny testament to the wonders of modern medicine.
But what Time failed to note is that the babies and their families are not the only beneficiaries of this progress. It turns out these infinitely vulnerable patients have become cash cows for the hospitals treating them. Indeed, for many hospitals, a steady flow of such patients is critical to the bottom line.
The reason is simple: Insurance reimbursements are usually higher for inpatients and for procedure- and technology-intensive medicine. Premature babies check both boxes; from a revenue perspective, they are ideal hospital patients.
Children's hospitals, which provide a disproportionate amount of care to poor kids on public insurance, can be especially dependent on their NICUs. According to Farzan Bharucha, a consultant with Kurt Salmon, it is "not uncommon for the NICU today to represent 50% or more of a children's hospital's total clinical revenue base." That helps to explain why they routinely dedicate a quarter or more of their beds to NICU care - and bank on keeping them filled.
Without these patients, many children's hospitals would likely have to curtail other vital services or perhaps even close.
There is certainly no shortage of such patients. With nearly 500,000 babies born before 37 weeks of pregnancy annually in the U.S., the preterm birth rate is the highest in the industrialized world, with nearly 1 in 8 babies born early. And, tragically, the rate of prematurity in this country has risen by 30% since 1981.
Premature birth is the leading cause of infant mortality, and preterm babies remain at greater risk for a host of ongoing health problems, from developmental delays to severe disabilities like cerebral palsy and blindness.
Prematurity is a financial burden as well. According to the March of Dimes, babies born before 32 weeks have an average hospital bill of $280,000, about 56 times as much as a healthy full-term baby. A great deal of that money goes toward NICU care. The March of Dimes says prematurity costs U.S.
employers more than $12 billion a year in excess health costs.
Those numbers are increasingly having real economic repercussions. In February, AOL CEO Tim Armstrong made headlines when he announced that the company would have to reduce employee benefits on account of two "distressed babies" that cost AOL about $1 million each.
If you loved this short article and you would like to acquire extra facts with regards to hospitality hotel jobs kindly go to our web site. Amid the ensuing controversy, he restored the benefits. But the financial tug-of-war won't go away anytime soon.
If hospitals want to stay in business, they have little choice but to conform to a payment regime that privileges providing certain kinds of care to certain kinds of patients. But when it comes to caring for the most fragile children, these systematic biases can devastate patients and their families.
The NICU Calculus U.S. hospitals have become very good at saving preemies; babies born at 27 weeks now survive about 90% of the time. But a system that emphasized prevention over treatment would likely result in better general pediatric health and save billions.
Children's Hospital of PittsburghAn image from the Children's Hospital of Pittsburgh website.Spending in the NICU is "a terrible anomaly and it heavily distorts our healthcare system in bizarre and unfortunate ways," says Dr. Craig Jackson, medical director of neonatology at Seattle Children's Hospital.
"Instead of caring for 500-gram (1.1 pound), 23-week-gestation babies and spending $200,000 on them, we could be spending that money on preventative care, obesity, or pick your favorite topic, and you'll save hundredfold more lives."
That said, he recognizes that it's a critical revenue engine. "Our neonatology program is responsible for subsidizing those noninterventional pediatricians that we desperately need and count on," Jackson says. The proceeds are "used to spread around and make everybody whole as best we can."
Some experts say there's not enough emphasis on prevention. No one cause triggers prematurity, but it has been correlated to factors including poverty, race (blacks are more likely to be born premature than whites), inadequate time between pregnancies, stress, and smoking or drinking during pregnancy.
Still, the March of Dimes believes a number of inexpensive interventions, including smoking-cessation programs and progesterone treatments could have promising results. A 2012 study in the American Journal of Obstetrics and Gynecology found that a model known as centering pregnancy - in which groups of women meet throughout their pregnancy for checkups, education, and mutual support - reduced prematurity and increased birth weights.
It showed especially strong results for black women.