Hospital factors associated with higher costs in pediatric blunt abdominal trauma: A national study
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Read the article on jpedsurg.org ↗Article · Feb 2019 · 1 min read
In brief
In brief
National database study of 1,104 pediatric blunt abdominal trauma cases finds no cost difference between children's and non-children's hospitals, but significantly higher costs at rural facilities (2.35-2.78× urban teaching hospitals). Geographic region and hospital ownership also influence costs, suggesting potential care standardization gaps in rural pediatric trauma management.
Written by the GCMD Library team from the article.
Background/Purpose
Our objective was to evaluate hospital factors, including children's hospital status, associated with higher costs for blunt solid organ pediatric abdominal trauma.
Methods
We queried the 2012 Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) for patients 18 years or younger with low-grade and high-grade blunt abdominal trauma. We calculated total hospital costs and adjusted cost ratios (CR) controlling for patient and hospital-level characteristics.
Results
The 2012 KID included 882 low-grade and 222 high-grade pediatric abdominal trauma patients. Median (interquartile range) per hospitalization costs were similar at children's and nonchildren's hospitals for both low-grade (children's = $6575 [$4333–$10,862], nonchildren's $7027 [$4230–$12,219] p = 0.47) and high-grade (children's = $10,984 [$6211- $20,007] nonchildren's $10,156 [$5439–$18,404] p = 0.55) groups. Adjusted cost ratios demonstrated higher costs in the West and among investor owned hospitals for low-grade and high-grade injuries, respectively. Costs at rural hospitals were higher in both groups (low-grade CR = 2.35 95% CI 2.02, 2.74, high-grade CR = 2.78 95% CI 2.13, 3.63) compared to urban teaching hospitals. Cost ratios did not differ based on children's hospital status.
Conclusion
Hospital costs were similar for children's and nonchildren's hospitals caring for pediatric abdominal trauma. Costs at rural hospitals are higher and may suggest financial instability or nonstandardized care of pediatric trauma patients.
Level of evidence
III