Characterizing Hospitalization Cost for Term Newborns in Intensive Care: A Multi-Center Analysis Across U.S. Children's Hospitals.

Objective To characterize and compare direct medical costs, cost drivers, and diagnoses among term newborns admitted to neonatal and non-neonatal ICUs at U.S. children's hospitals. Study Design Retrospective cohort study of term newborns (≥ 37 weeks' gestation) admitted to ICUs within 7 days of birth between 1/1/2022 and 12/31/2024, using the Pediatric Health Information System. Results Among 45,738 term infants at 42 hospitals, non-neonatal ICU admissions represented 8% of encounters but 25% of costs ($912 million). Median cost was $20,367 [IQR: $8,336 - $59,887], with room and board as the primary driver in both settings. Higher costs were independently associated with medical complexity (≥ 4 chronic conditions; RR 6.05, 95% CI 5.15-7.09) and illness severity (RR 1.07 per unit increase, 95% CI 1.07-1.07). Conclusions Term newborns requiring intensive care incurred high costs, driven by medical complexity and acuity, providing national benchmark data to inform future efforts to optimize care delivery.