Benefits of Exclusive Breastfeeding for 6 months of Life: A cost analysis in a Medicaid population Open Access

Caplea, Andrea Lindley (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/nk322d85j?locale=en
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Abstract

Objectives: Evidence suggests cost savings if exclusive breastfeeding for 6 months national goals are met. This analysis fills a knowledge gap of inpatient Medicaid cost expenditures due to exclusive breastfeeding percentages under goal. It was hypothesized that in a Medicaid population, exclusive breastfeeding for 6 months is cost effective in comparison to other feeding methods with regards to inpatient hospitalizations averted due to the high prevalence primary diagnoses of lower respiratory tract infections (LRTI) and gastroenteritis.

Methods: A decision analysis model was built. Analysis included determination of the under 1 year of age US population with Medicaid insurance, the percentages of exclusive breastfeeding versus non-breastfeeding within this group, and the incidence of hospitalization for LRTI and gastroenteritis in each cohort. Costs were then calculated for each cohort and diagnosis. This methodology was repeated for the national US exclusive breastfeeding percentage and the Healthy People 2020 goal percentage.

Results: If Medicaid exclusive breastfeeding percentage at 6 months increased from its current level of 10.0% to the current national exclusive breastfeeding percentage at 6 months of 16.3%, more than $14,234,680 could be saved annually due to averted pediatric hospitalizations secondary to LRTI and gastroenteritis. If Medicaid exclusive breastfeeding percentage at 6 months increased to the Healthy People 2020 exclusive breastfeeding percentage at 6 months goal of 25.5%, more than $35,000,000 could be saved annually due to averted pediatric hospitalizations secondary to LRTI and gastroenteritis.

Conclusions: Medicaid breastfeeding percentages are below US National breastfeeding percentages and well below Healthy People 2020 goal percentages; this difference is costly in terms of infant morbidity as well as inpatient hospitalization costs. Appropriate cost research may encourage further outreach aimed to increase exclusive breastfeeding in Medicaid recipients.

Table of Contents

Table of Contents

Title:

Benefits of Exclusive Breastfeeding for 6 months of Life:

A cost analysis in a Medicaid population 5

ACKNOWLEDGEMENTS 6

Abbreviations 9

Introduction 10

Figure 1. Percentage of US Children (ages 0-5) ever breastfed, National Survey of Children's Health 14

Figure 2: Percentage of US Children Exclusively Breastfed for 6 months, National Immunization Survey 15

Research Question 17

Problem and Purpose Statements 17

Significance Statement 18

Definitions 18

Literature Review 18

Design and Methodology 22

Data Sources 23

Methodology 25

Figure 3: Decision Analysis Model 26

Data Collection, Analysis, and Results 27

Figure 4. Overall hospitalization rates and Odds ratios in favor of breastfeeding 28

Figure 5. Hospitalization Incidence at each percentage: Current Medicaid Breastfeeding Percentage, Current US Population Breastfeeding Percentage, Healthy People 2020 Goal Percentage 29

Results 30

Figure 6. Summary Table: Total and Projected Costs 30

Discussion 32

Study limitations and assumptions 33

Disclaimer 34

Appendix 1. Total Costs, Inclusive of Current and Projected Costs 40

APPENDIX 2: Journal Article 41

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