Health Care Expenditures and Utilization for Children With Noncomplex Chronic Disease

Hoefgen, Erik R.; Andrews, Annie Lintzenich; Richardson, Troy; Hall, Matthew; Neff, John M.; Macy, Michelle L.; Bettenhausen, Jessica L.; Shah, Samir S.; Auger, Katherine A.

doi:10.1542/peds.2017-0492

Cited by 24 publications

(35 citation statements)

References 33 publications

(20 reference statements)

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“…This is in contrast to a previous research, which found pediatric chronic conditions and presence of neuromuscular complex chronic condition were more likely to have high spending in pediatric population with Medicaid insurance . Additionally, pediatric patients with noncomplex chronic diseases were also reported to incur higher healthcare expenditure than those without chronic diseases . We believe that gastrostomy and ileostomy are possibly helpful in reducing the symptoms and the associated needs for inpatient stays, but further prospective studies are needed to better define healthcare utilization in the presence of comorbid conditions among this population.…”

Section: Discussioncontrasting

confidence: 82%

“…Finally, this is the first review to assess healthcare burden in the pediatric chronic intestinal pseudo‐obstruction population. This is of incredible importance given the growing evidence of increasing healthcare utilization of chronic diseases in the pediatric population . Even though rare, our analysis finds that pediatric intestinal pseudo‐obstruction inpatient admissions resulted in a high healthcare burden incurring a total cost of hospitalization ranging from $45 000 to $54 000.…”

Section: Discussionmentioning

confidence: 89%

“…Pediatric intestinal pseudo‐obstruction is a rare disorder with severe morbidity and mortality . Long term relapses of disease for pediatric patients with chronic conditions often result in inpatient hospital admissions and high healthcare burden . However, due to the rarity of pediatric intestinal pseudo‐obstruction, specific demographic estimation and quantification of healthcare burden is difficult to assess.…”

Section: Discussionmentioning

confidence: 99%

“…There is limited understanding of the epidemiology and healthcare burden of this disease due to rarity of the disease and complexity of diagnosis. Additionally, there is growing evidence of increased healthcare utilization for pediatric patients with chronic conditions . We aim to characterize the incidence and healthcare utilization related to inpatient admissions among children with pediatric intestinal pseudo‐obstruction in the United States.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Batra

Rahman

Rana

et al. 2019

Neurogastroenterology Motil

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Background Pediatric intestinal pseudo‐obstruction is a rare disorder affecting gastrointestinal motility leading to chronic symptoms and hospitalizations. There is limited understanding of the epidemiology and healthcare burden. Methods We analyzed data from Kids' Inpatient Database from 2016, which includes inpatient discharge records from US hospitals. ICD‐10 codes were used to identify patients 0‐18 years with pediatric intestinal pseudo‐obstruction and comorbid conditions. Multivariable logistic regression and Wilcoxon rank‐sum test were used. Results In 2016, there were 1671 inpatient discharges from US hospitals for patients 0‐18 years of age with this diagnosis. The incidence of inpatient admission was 29/100 000 patients. After controlling for age, race, income status, and insurance, males vs females (adjusted odds ratio, aOR: 1.10; 95% CI: 0.94‐1.28; P = .241) and caucasians vs other races (aOR: 1.55; 95% CI: 1.27‐1.88; P < .001) were more likely to be admitted. Inpatient admissions incurred significant healthcare burden; median (inter quartile range IQR) cost of hospitalization of US$ 52 079 (US$ 23 530‐120 961) and a median (IQR) length of stay of 6 days (3‐14 days). Gastrostomy (32%) and ileostomy (12.6%) status appeared to incur lower healthcare burden. Parenteral nutrition, malnutrition, and central line/bloodstream infections resulted in higher healthcare burden. Conclusions Pediatric intestinal pseudo‐obstruction is a rare diagnosis with a high incidence of inpatient admissions and healthcare burden. An aggressive multidisciplinary management is crucial in reducing inpatient admissions in this cohort.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Batra

Rahman

Rana

et al. 2019

Neurogastroenterology Motil

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“…In this study, we found that early survivors of pediatric cancer have high rates of morbidity, including multimorbidity, and that the number of conditions they experience is significantly associated with their healthcare utilization and expenditures. The prevalence of multimorbidity in the general pediatric population has been estimated at 12%, with annual costs per child (among those with chronic conditions) ranging from $2801 to $12 569, depending on complexity . We observed three times that prevalence among the early survivor cohort, and significantly higher costs.…”

Section: Discussionmentioning

confidence: 65%

Multimorbidity and healthcare utilization among early survivors of pediatric cancer

Harrington

Qato

Antoon

et al. 2019

Pediatric Blood & Cancer

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Early survivors of pediatric cancer are at increased risk of experiencing chronic conditions; however, little is known about the morbidity burden in this population. In this observational cohort study of commercially insured pediatric cancer survivors in the United States (2009–2014), we find that 22.5% of survivors had one chronic condition, and 36.3% had multiple. Compared with survivors without chronic conditions, the presence of multiple conditions significantly increased the odds of an emergency department visit by 70% (odds ratios [OR], 1.7; 95% confidence interval [CI], 1.4–2.1) and of a hospitalization almost four‐fold (OR, 3.8; 95% CI], 2.5–5.5). Findings are important for informing pediatric survivorship care plans in the years following completion of therapy.

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Correlation Between National Institutes of Health Funding for Pediatric Research and Pediatric Disease Burden in the US

et al. 2021

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NIH) is the largest government funding source for biomedical research globally. Burden of disease is one of the factors considered by the NIH in making funding allocations, though it is not known how funding patterns are associated with disease burden for pediatric conditions. OBJECTIVE To determine the correlation between NIH funding and disease burden across pediatric conditions. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study evaluates NIH grants funding pediatric research from 2015 to 2018 in the US. Pediatric grants were classified according to disease categories studied. Disease burden for each category was determined using measures from the Institute of Health Metrics and Evaluation and hospitalization data from the 2016 Kids' Inpatient Database. MAIN OUTCOME AND MEASURECorrelation between NIH funding and pediatric disease burden using Spearman rank order coefficients and predicted amounts of disease-specific funding based on disease burden estimated from linear regression models. RESULTSThis study analyzed 14 060 disease-specific pediatric grants awarded by the NIH from 2015 to 2018 in the US. Annual funding for disease categories ranged from $0 to $382 849 631. Funding for pediatric research was correlated with pediatric disability-adjusted life-years (DALYs), deaths, years lived with disability, and years of life lost (r, 0.56-0.63; P < 0.001 for all measures). There was also a correlation between funding and hospital-based metrics, including hospital days, number of hospital admissions, and hospital charges (r, 0.67-0.69; P < .001 for all measures). Eight disease categories received greater than $500 million more than predicted levels relative to DALYs, while 5 disease categories were funded more than $50 million less than predicted levels. Based on predicted levels of funding, congenital birth defects; endocrine, metabolic, blood, and immune disorders; and HIV/AIDS were the most overfunded categories relative to DALYs and hospital days. Conditions identified as most underfunded differed depending on use of DALYs or hospital days in estimating predicted funding levels.CONCLUSIONS AND RELEVANCE NIH funding for pediatric research was correlated with pediatric disease burden in the US with variable correlation based on the disease metric applied. There was substantial overfunding and underfunding of certain conditions. Ongoing evaluation of pediatric funding patterns using a complementary set of disease measures may help inform and prioritize pediatric research funding.

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Health Care Expenditures and Utilization for Children With Noncomplex Chronic Disease

Cited by 24 publications

References 33 publications

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Multimorbidity and healthcare utilization among early survivors of pediatric cancer

Correlation Between National Institutes of Health Funding for Pediatric Research and Pediatric Disease Burden in the US

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