Investigators compared all cocaine-exposed infants born in a large, publicly funded inner-city hospital (n=355) with a random sample of non-exposed infants born in the same hospital (n=199) to examine the added neonatal cost and length of hospital stay associated with fetal cocaine exposure. Between September 1, 1985 and August 31, 1986, all newborn infants were screened by urine test for illicit substances, and medical records were reviewed for maternal histories of substance abuse. The cocaine-exposed group consisted of all single live births who were identified by either maternal history or infant urine assay. The control group was comprised of single live births for whom no drug use history was indicated by either maternal history or infant urine test. Investigators assessed a total of 129 variables. Outcome measures included the cost and length of stay for each infant until medically cleared for hospital discharge, as well as the cost and length of stay for each infant until actual discharge from the hospital.

The present study examines the added newborn cost and length of hospital stay associated with prenatal exposure to cocaine. Newborn costs for cocaine-exposed infants were compared to those of a random sample of unexposed infants delivered in the same hospital during the same time period. National estimates of diagnosis related group (DRG) per diem costs of care for newborns were used to generate estimates of the costs of hospital care. Costs and lengths of stay were subdivided into those that were medically necessary and those generated by "boarder babies" (infants who are medically cleared for discharge but who remain in the hospital while awaiting social evaluation or placement in the foster care system). Data were gathered on related variables such as prenatal care, maternal smoking and alcohol use, race, gravidity, maternal age, gender of the infant, crack exposure and exposure to multiple illicit substances.