Working Paper: NBER ID: w4673
Authors: Theodore Joyce; Andrew D. Racine; Sandra McCalla; Hassan Wehbeh
Abstract: This paper determines newborn costs and lengths of stay attributable to prenatal exposure to cocaine and other illicit drugs, using as a data source all parturients who delivered at a large municipal hospital in New York City between November 18, 1991 and April 11, 1992. We performed a cross-sectional analysis in which multivariate, loglinear regressions were used to analyze differences in costs and length of stay between infants exposed and unexposed prenatally to cocaine and other illicit drugs adjusting for maternal race, age, prenatal care, tobacco, parity, type of delivery, birth weight, prematurity, and newborn infection. Urine specimens, with linked obstetric sheets and discharge abstracts provided information on exposure, prenatal behaviors, costs, length of stay and discharge disposition. Our principal findings show that infants exposed to cocaine and some other illicit drug stay approximately 7 days longer at a cost of $7,731 more than infants unexposed. Approximately 60 percent of these costs are indirect, the result of adverse birth outcomes and newborn infection. Hospital screening as recorded on discharge abstracts substantially underestimates prevalence at delivery, but overestimates its impact on costs.
Keywords: prenatal exposure; cocaine; newborn costs; length of stay; illicit drugs
JEL Codes: I12; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Prenatal exposure to cocaine (I12) | Increased newborn costs (J13) |
| Prenatal exposure to cocaine (I12) | Increased length of stay (C41) |
| Cocaine exposure (I12) | Length of stay (C41) |
| Cocaine exposure (I12) | Hospital-specific costs (I23) |
| Known exposure to cocaine at delivery (I19) | Greater costs (H59) |
| Known exposure to cocaine at delivery (I19) | Greater length of stay (C41) |