Health Care Expenditures and Utilization for Children With Noncomplex Chronic Disease.

Autor:	Hoefgen ER; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; erik.hoefgen@cchmc.org., Andrews AL; Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina., Richardson T; Department of Analytics, Children's Hospital Association, Overland Park, Kansas., Hall M; Department of Analytics, Children's Hospital Association, Overland Park, Kansas., Neff JM; Department of Pediatrics, School of Medicine, University of Washington and Seattle Children's Hospital, Seattle, Washington., Macy ML; Department of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan; and., Bettenhausen JL; Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri., Shah SS; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio., Auger KA; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2017 Sep; Vol. 140 (3). Date of Electronic Publication: 2017 Aug 01.
DOI:	10.1542/peds.2017-0492
Abstrakt:	Background: Pediatric health care expenditures and use vary by level of complexity and chronic illness. We sought to determine expenditures and use for children with noncomplex chronic diseases (NC-CDs). Methods: We performed a retrospective, cross-sectional analysis of Medicaid enrollees (ages 0-18 years) from January 1, 2012, through December 31, 2013, using administrative claims (the Truven MarketScan Medicaid Database). Patients were categorized by chronicity of illness by using 3M Health Information System's Clinical Risk Groups (CRGs) as follows: without chronic diseases (WO-CDs) (CRG 1-2), NC-CDs (CRG 3-5), and complex chronic diseases (C-CDs) (CRG 6-9). Primary outcomes were medical expenditures, including total annualized population expenditure and per-member per-year expenditure (PMPY). Secondary outcomes included the number of health care encounters over the 2-year period. Results: There were 2 424 946 children who met inclusion criteria, 53% were WO-CD; 36% had an NC-CD; and 11% had a C-CD. Children with NC-CDs accounted for 33% ($2801 PMPY) of the annual spending compared with 20% ($1151 PMPY) accounted for by children WO-CDs and 47% ($12 569 PMPY) by children with C-CDs. The median outpatient visit count by group over the 2-year period was 15 (interquartile range [IQR] 10-25) for NC-CD, 8 (IQR 5-13) WO-CD, and 34 (IQR 19-72) for C-CD. Conclusions: Children with NC-CDs accounted for 33% of pediatric Medicaid expenditures and have significantly higher PMPY and aggregate annual expenditures than children WO-CDs. The annual aggregate expenditures of the NC-CD group represent a significant societal cost because of the high volume of children, extrapolated to ∼$34.9 billion annually in national Medicaid expenditures. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2017 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu