Cost of care for a geographically determined population of low birthweight infants to age 8-9 years .2. Children with disability

Aim-To determine the cost of health and educational service provision for low birthweight children with a clinical disability. Methods-Cohort study of a geographically defined population in five health districts that comprise the County of Merseyside was undertaken. All children with a clinical disability born in 1980 and 1981 to mothers resident in the County of Merseyside were followed up to age 8-9 years. The cost of care associated with the initial admission to the neonatal special/ intensive care unit and subsequent use of hospital, family practitioner, and special education services was assessed. Results-There were 52 children with a disability; the disability rate in children of birthweight less than or equal to 2000 g was estimated at 7.7%. Of the total expenditure to age 8-9 years, special education was the largest category (52%) and neonatal care accounted for 35%. The disabled children accounted for 38% of the cost of the whole cohort of 693 disabled and non-disabled children who weighed less than or equal to 2000 g at birth. Conclusion-In a cohort of low birthweight children, those who are disabled account for a disproportionate amount of the total expenditure to age 8-9. The cost of long term care for disabled young persons and adults will increasingly dominate the cost of care for the whole cohort of low birthweight children.