# Implementation of Family Integrated Care in the Neonatal Intensive Care Unit, University Hospitals Sussex, UK

## TL;DR

Family Integrated Care (FICare) in neonatal units reduced high-dependency care duration and costs for babies, suggesting potential resource and cost savings.

## Contribution

This study provides real-world evidence of FICare's potential cost-saving benefits in neonatal care through economic evaluation and clinical audit.

## Key findings

- Infants receiving FICare spent fewer days in high-dependency care (10 days in 2024 vs. 13 days in 2021).
- The total cost per baby's NICU stay decreased from GBP 63,279 in 2021 to GBP 59,284 in 2024.
- Duration of invasive ventilation and CPAP use decreased after FICare implementation.

## Abstract

What are the main findings?
The duration of stay on ventilation and high-dependency care was lower after implementing FICare;The cost of stay in NICU was lower for babies receiving FICare.

The duration of stay on ventilation and high-dependency care was lower after implementing FICare;

The cost of stay in NICU was lower for babies receiving FICare.

What are the implications of the main findings?
This was a pragmatic, non-randomised, non-controlled study based on economic evaluation and clinical audit, which provided evidence on FICare implementation in real-life conditions;The study suggests that FICare may be resource-and cost-saving due to a decrease in babies’ stay in high-dependency care.

This was a pragmatic, non-randomised, non-controlled study based on economic evaluation and clinical audit, which provided evidence on FICare implementation in real-life conditions;

The study suggests that FICare may be resource-and cost-saving due to a decrease in babies’ stay in high-dependency care.

Background/Objectives: Family Integrated Care (FICare) is a model of care for preterm or critically ill infants in which families are considered equal partners with clinical teams and are fully integrated into all aspects of care and decision-making. In this study, we conducted a health economics study of FICare implementation in the UK, as part of the EU-funded international, interdisciplinary, and intersectoral project RISEinFamily. Methods: An economic evaluation of healthcare services and an audit of clinical outcomes for infants admitted to the Royal Sussex County Hospital and the Princess Royal Hospital neonatal units in 2021 (at the start of FICare) and 2024 (when FICare was fully integrated into clinical practice) were conducted. Anonymized data on hospital admissions were downloaded from the hospital database. Infants with a duration of stay in the NICU of more than 20 days were included in the analysis. The cost of NICU stay was estimated using the Health Resource Group codes. Results: The average duration of infants’ stay in NICU was similar before and after the implementation of FICare (47 days (SD 29) in 2021 and 47 days (SD 31) in 2024). However, the infants who received FICare spent fewer days in high-dependency care; on average, 10 days in 2024 and 13 days in 2021. The duration of invasive ventilation fell by 12% and the duration of CPAP by 26% after introducing FICare. The total cost per baby stay in NICU was GBP 63,279 (USD 87,021) in 2021 and GBP 59,284 (USD 75,777) in 2024. Conclusions: Although the changes did not reach statistical significance, the study suggests that FICare may be resource- and cost-saving due to reducing infants’ stays in high-dependency care.