{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:30:58Z","timestamp":1789803058726,"version":"4.0.1"},"reference-count":11,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,3,1]]},"abstract":"<jats:p>Context. Although the increasing effectiveness of neonatal programs for extremely low birth weight (ELBW, birth weight &amp;lt;1000 g) infants has been established from cohort studies, there is a paucity of data on the relationship between the costs and the consequences of neonatal intensive care.<\/jats:p>\n               <jats:p>Objective. To determine the changes in the efficiency of neonatal intensive care for ELBW infants in Victoria, Australia over 2 decades.<\/jats:p>\n               <jats:p>Design. Economic evaluation (cost-effectiveness and cost-utility analyses) in a population-based cohort study of consecutive ELBW infants born during 4 distinct eras (1979\u20131980, 1985\u20131987, 1991\u20131992, and 1997) followed to at least 2 years of age.<\/jats:p>\n               <jats:p>Setting. The state of Victoria.<\/jats:p>\n               <jats:p>Patients. All ELBW live births of birth weight 500 to 999 g in the state in the calendar years indicated (1979\u20131980: n = 351; 1985\u20131987: n = 560; 1991\u20131992: n = 429; 1997: n = 233).<\/jats:p>\n               <jats:p>Main Outcome Measures. Costs were assessed primarily by the consumption of hospital resources. The consequences included survival and quality-adjusted survival rates at 2 years of age.<\/jats:p>\n               <jats:p>Results. The cost-effectiveness ratios (expressed in Australian dollars for 1997) were similar between successive eras at $5270, $3130, and $4050 per life-year gained, respectively. The cost-utility ratios were similar between successive eras at $5270, $3690, and $5850 per quality-adjusted life-year gained, respectively, and were similar to the cost-effectiveness ratios. The cost-effectiveness and cost-utility ratios were generally higher in lower birth-weight subgroups, but there were consistent gains in efficiency over time in infants of lower birth weight.<\/jats:p>\n               <jats:p>Conclusions. As there have been large increases in effectiveness from the late 1970s to the late 1990s, the efficiency of neonatal intensive care for ELBW infants in Victoria has remained relatively stable.<\/jats:p>","DOI":"10.1542\/peds.113.3.510","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:53:04Z","timestamp":1092444784000},"page":"510-514","source":"Crossref","is-referenced-by-count":56,"title":["Evaluation of Neonatal Intensive Care for Extremely Low Birth Weight Infants in Victoria Over Two Decades: II. Efficiency"],"prefix":"10.1542","volume":"113","author":[{"given":"Lex W.","family":"Doyle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Victorian Infant Collaborative Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2004,3,1]]},"reference":[{"key":"2021121006125061900_R1","doi-asserted-by":"crossref","unstructured":"Doyle LW, the Victorian Infant Collaborative Study Group. Evaluation of neonatal intensive care for extremely low birth weight infants in Victoria over two decades. 1: Effectiveness. Pediatrics.2004;3:505\u2013509","DOI":"10.1542\/peds.113.3.505"},{"key":"2021121006125061900_R2","doi-asserted-by":"crossref","unstructured":"Zupancic JA, Richardson DK, Lee K, McCormick MC. Economics of prematurity in the era of managed care. Clin Perinatol.2000;27:483\u2013497","DOI":"10.1016\/S0095-5108(05)70032-4"},{"key":"2021121006125061900_R3","doi-asserted-by":"crossref","unstructured":"Sinclair JC, Torrance GW, Boyle MH, Horwood SP, Saigal S, Sackett DL. Evaluation of neonatal-intensive-care programs. N Engl J Med.1981;305:489\u2013494","DOI":"10.1056\/NEJM198108273050904"},{"key":"2021121006125061900_R4","doi-asserted-by":"crossref","unstructured":"Boyle MH, Torrance GW, Sinclair JC, Horwood SP. Economic evaluation of neonatal intensive care of very-low-birth-weight infants. N Engl J Med.1983;308:1330\u20131337","DOI":"10.1056\/NEJM198306023082206"},{"key":"2021121006125061900_R5","doi-asserted-by":"crossref","unstructured":"Kitchen WH, Bowman E, Callanan C, et al. The cost of improving the outcome for infants of birthweight 500\u2013999 g in Victoria. The Victorian Infant Collaborative Study Group. 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