The study’s goal was to evaluate the cost-effectiveness of postoperative feeding recommendations to normal feeding practices in reducing complications in babies undergoing intestinal surgery. Using data from a cohort study, Markov models from the health care and societal perspectives simulated hospitalization expenses for babies fed according to guidelines vs normal practice. Intestinal failure–associated liver disease, necrotizing enterocolitis following feeding, sepsis, and death were among the short-term outcomes. The length of stay was used to determine effectiveness. The incremental cost-effectiveness ratios (ICER) compared the cost of care to the duration of stay. Univariate and multivariate probabilistic sensitivity assessments were carried out using 10,000 Monte Carlo simulations. A second decision tree model calculated the cost per quality-adjusted life-year (QALY) by including utilities related to long-term outcomes. In terms of hospital costs, normal feeding costs $31,258,902 and 8296 hospital days, whereas feeding recommendations cost $29,295,553 and 8096 hospital days. With guideline usage, the ICER was $9832 per hospital stay. More than 90% of the ICERs were located in the dominating quadrant. From a social standpoint, the results were identical. Long-term costs and utilities in the guideline group were $2830 and 0.91, respectively, compared to $4030 and 0.90 in the control group, resulting in an ICER of $91,756/QALY. 

In the models, following feeding guidelines resulted in cost savings and a shorter hospital stay in the short term, as well as cost savings and an increase in QALYs in the long run. A systematic method to feeding surgical babies appears to prevent expensive problems, but more evidence from a bigger group is required.