A micro-costing model of neonatal intensive care from a tertiary Indian unit: feasibility and implications for insurance.

OBJECTIVE To calculate and compare costs of neonatal intensive care by micro-costing and gross-costing methods. METHODS The costs of resources of a tertiary care neonatal intensive care unit were estimated by the two methods to arrive at specific costs per diagnosis related categories for 33 neonates followed-up prospectively. RESULTS Gross-costing as compared to micro-costing resulted in higher cost per bed (Rs 6315 vs. Rs 4969) and wide variations of costs (-34.8% to +13.4%). Intensity of interventions, relative stay in neonatal intensive care unit compared to the step-down nursery, and total length of hospital admission accounted for these variations. CONCLUSION Estimates based on micro-costing arrived in this study may be used as a starting point in developing assumptions for insurance models covering neonatal intensive care.