Hospital Utilization Among Children With the Highest Annual Inpatient Cost

Pediatrics
Alon PeltzJay Berry

Abstract

Children who experience high health care costs are increasingly enrolled in clinical initiatives to improve their health and contain costs. Hospitalization is a significant cost driver. We describe hospitalization trends for children with highest annual inpatient cost (CHIC) and identify characteristics associated with persistently high inpatient costs in subsequent years. Retrospective study of 265 869 children age 2 to 15 years with ≥1 admission in 2010 to 39 children's hospitals in the Pediatric Health Information System. CHIC were defined as the top 10% of total inpatient costs in 2010 (n = 26 574). Multivariate regression and regression tree modeling were used to distinguish individual characteristics and interactions of characteristics, respectively, associated with persistently high inpatient costs (≥80th percentile in 2011 and/or 2012). The top 10% most expensive children (CHIC) constituted 56.9% ($2.4 billion) of total inpatient costs in 2010. Fifty-eight percent (n = 15 391) of CHIC had no inpatient costs in 2011 to 2012, and 27.0% (n = 7180) experienced persistently high inpatient cost. Respiratory chronic conditions (odds ratio [OR] = 3.0; 95% confidence interval [CI], 2.5-3.5), absence of surgery in 2010 (OR = 2.0;...Continue Reading

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Citations

May 2, 2017·Academic Pediatrics·Carlos F Lerner, Thomas S Klitzner
Jul 11, 2019·Current Opinion in Pediatrics·Mary Ann de BanateMatthew Sadof
Nov 20, 2019·Journal for Specialists in Pediatric Nursing : JSPN·Songul Cinaroglu
Apr 30, 2017·Journal of Palliative Medicine·Prasanna AnanthJoanne Wolfe
Aug 23, 2020·Journal of Pediatric Gastroenterology and Nutrition·Rachel RosenStacy A Kahn
Dec 11, 2020·Hospital Pediatrics·Victoria ParenteDavid Ming
Oct 24, 2020·Journal of Pediatric Gastroenterology and Nutrition·Rachel RosenStacy A Kahn
Apr 4, 2021·International Journal of Environmental Research and Public Health·Alicia Aurora RodríguezNicole Passi
Jul 27, 2021·JAMA Network Open·Peter J GillUNKNOWN Pediatric Research in Inpatient Setting (PRIS) Network
Jul 31, 2021·The Journal of Pediatrics·Rose HardyDeena Chisolm
Aug 3, 2017·Pediatrics·Eyal CohenJay G Berry
Apr 2, 2020·Pediatrics·Mary L Ehlenbach, Ryan J Coller

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