163 - Cost-savings Analysis of a Remote Home Monitoring Feeding Program for NICU Graduates: A Prospective Pilot Cohort Study

Poster Number: 163
Publication Number: 163.2252

Background: For premature neonates in the NICU, full safe oral feeding (SOF) is a milestone before discharge. Prolonged NICU stays to achieve full SOF increase costs, infection risk, neurodevelopmental issues, and family stress. Remote home monitoring uses telemedicine technologies to deliver health care in the home environment, enabling patients to discharge earlier while still receiving medical care and support.

Objective: Evaluate the safety, feasibility, and cost-savings of our Remote Home Monitoring Program (RHMP) in achieving SOF for NICU graduates.

Design/Methods: This prospective cohort pilot study with retrospective cost analysis was conducted in our level 3 NICU in Indianapolis, IN from August 2022-2023. We offered eligible NICU patient families enrollment in our RHMP or receive NICU standard care to achieve SOF. See Figure 1 for eligibility and exclusion criteria. The main outcome measure for the cost-analysis was the average hospital cost per patient for neonates achieving full SOF, comparing participants in the RHMP to the control group (those in the NICU until discharge). To minimize selection bias, a core NICU team approached eligible patient families for enrollment using scripted talking points and a standardized protocol. Parents demonstrated safe oral feeding, and received gavage and Locus Health© web-based and application training prior to discharge. Confounding variable data collection included patient sex, race/ethnicity, type of insurance, gestational age, and birthweight parameters. We used t-tests to assess statistical significance in cost differences and other variables.

Results: Out of 43 eligible patients, 24 were enrolled in the RHMP (Figure 1). Birth gestational age < 32 weeks and small for gestational age (p-values < 0.05) were statistically significant baseline characteristics (Table 1). The failure rate for non-enrollees achieving full SOF was 29.1%, compared to 26.3% for those enrolled (p=0.417). SOF failure reasons for non-enrollees and enrollees are outlined in Figure 1. The average healthcare costs per patient enrolled in the RHMP was $69,356 compared to $83,105 for those receiving standard NICU care (p=0.059), with an average cost savings of $13,747 per enrolled patient (Table 1 & Figure 2), and total estimated cost-savings of $329,928 over 12 months.

Conclusion(s): Our pilot project demonstrated the RHMP is safe and feasible with a significant cost-savings and a SOF failure rate comparable to standard NICU care. Expansion of this program can reduce healthcare costs, increase access to NICU beds, and increase family bonding.
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