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
Benefits of Exclusive Breastfeeding for 6 months of Life:
A cost analysis in a Medicaid population 5
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
Literature Review 18
Design and Methodology 22
Data Sources 23
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
Figure 6. Summary Table: Total and Projected Costs 30
Study limitations and assumptions 33
Appendix 1. Total Costs, Inclusive of Current and Projected Costs 40
APPENDIX 2: Journal Article 41
About this Master's Thesis
|Committee Chair / Thesis Advisor|
|Benefits of Exclusive Breastfeeding for 6 months of Life: A cost analysis in a Medicaid population ()||2018-08-28||